Provider Demographics
NPI:1790954899
Name:OUR LADY OF BELLEFONTE HOSPITAL
Entity Type:Organization
Organization Name:OUR LADY OF BELLEFONTE HOSPITAL
Other - Org Name:BELLEFONTE PRIMARY CARE, ASHLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHHEIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-833-3333
Mailing Address - Street 1:PO BOX 2155
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2155
Mailing Address - Country:US
Mailing Address - Phone:606-326-9001
Mailing Address - Fax:
Practice Address - Street 1:2028 WINCHESTER AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7744
Practice Address - Country:US
Practice Address - Phone:606-326-9001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000556893OtherANTHEM BC/BS
OH2826080Medicaid
KY7100040070Medicaid
KY7100040070Medicaid
OH2826080Medicaid
KYCB3982Medicare PIN