Provider Demographics
NPI:1629007430
Name:OHIO COUNTY HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:OHIO COUNTY HOSPITAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PFS DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:DAUGHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-504-1910
Mailing Address - Street 1:1211 OLD MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:KY
Mailing Address - Zip Code:42347-1619
Mailing Address - Country:US
Mailing Address - Phone:270-298-5431
Mailing Address - Fax:270-298-5269
Practice Address - Street 1:1211 OLD MAIN ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:KY
Practice Address - Zip Code:42347-1619
Practice Address - Country:US
Practice Address - Phone:270-298-5431
Practice Address - Fax:270-298-5269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY600073282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1059060OtherKEYSTONE MERCY PASSPORT
KY000000061904OtherBLUE CROSS LAB PIN NUMB
KY100035350AOtherINDIANA MEDICAID
KY000000054290OtherBLUE CROSS HOSP PIN NUM
KY01022052Medicaid
KY030024700OtherFEDERAL BLACK LUNG
KY000000055515OtherBLUE CROSS PROFESSIONAL