Provider Demographics
NPI:1437156346
Name:OUR LADY OF BELLEFONTE HOSPITAL INC
Entity Type:Organization
Organization Name:OUR LADY OF BELLEFONTE HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCZKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-442-3373
Mailing Address - Street 1:1000 ST. CHRISTOPHER DR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7034
Mailing Address - Country:US
Mailing Address - Phone:606-833-3333
Mailing Address - Fax:
Practice Address - Street 1:1000 ST. CHRISTOPHER DR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7034
Practice Address - Country:US
Practice Address - Phone:606-833-3333
Practice Address - Fax:606-833-3593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6639203Medicaid
KY01000082Medicaid
KY01000082Medicaid