Provider Demographics
NPI:1538100995
Name:OHIO VALLEY HEARTCARE INC
Entity Type:Organization
Organization Name:OHIO VALLEY HEARTCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KC
Authorized Official - Middle Name:
Authorized Official - Last Name:FRESCOLN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:812-473-2642
Mailing Address - Street 1:901 SAINT MARYS DR
Mailing Address - Street 2:STE 300
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0520
Mailing Address - Country:US
Mailing Address - Phone:812-473-2642
Mailing Address - Fax:812-474-4458
Practice Address - Street 1:914 N ELM ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-2711
Practice Address - Country:US
Practice Address - Phone:270-830-6651
Practice Address - Fax:270-830-9811
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHIO VALLEY HEARTCARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-09
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Multi-Specialty
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78901425Medicaid
KY65910549Medicaid
KY65910549Medicaid