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Organization Active NPI

Owensboro Health Inc

Doing business as Owensboro Health Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Owensboro, KY
National Provider Identifier
1194149682
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P07614 Issued in KY
Legal business name
OWENSBORO HEALTH INC
Doing business as
Owensboro Health Outpatient Pharmacy
Practice address
1301 Pleasant Valley Rd
Suite 104
Owensboro, KY 42303-9774
Phone
(270) 417-6701
Fax
(270) 417-6705
NPI assigned
Feb 5, 2014
Last updated
Jun 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Russ Ranallo
Title
Vice President of Financial Service
Phone
(270) 685-7180

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X P07614 KY Primary
Mail Order Pharmacy 3336M0002X

Addresses

Primary practice location

1301 Pleasant Valley Rd
Suite 104
Owensboro, KY 42303-9774

Mailing address

1301 Pleasant Valley Rd
Suite 104
Owensboro, KY 42303-9774
Phone (270) 417-6701

Other names 1

  • Owensboro Health Outpatient Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140409000354 KY Part B Supplier - Mass Immunization (Roster Biller Only) 0547154650 Practice locations: Owensboro, KY

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

1301 Pleasant Valley Rd
Ste 104
Owensboro, KY 42303
Phone (270) 417-6701

Ownership & related parties

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Owensboro Health Muhlenberg Community HospitalGreenville, KY, CCN 180004 Hospital Operational/Managerial Control
Other (100%)		 May 1, 2014
Jul 1, 2015
Owensboro Health Twin Lakes Medical Center SwingLeitchfield, KY, CCN 18U070 Hospital Operational/Managerial Control Jan 1, 2021
Owensboro Health Muhlenberg Community Hospital Long Term CareGreenville, KY, CCN 185008 Skilled nursing facility Operational/Managerial Control
Other (100%)		 May 1, 2014
Jul 1, 2015
Owensboro Health Home Care ServicesOwensboro, KY, CCN 187112 Home health agency 5% Or Greater Direct Ownership Interest Jul 14, 1995
Owensboro Health Muhlengerg Community Hospital Home HealthCentral City, KY, CCN 187096 Home health agency Operational/Managerial Control May 1, 2014
Owensboro Health Muhlenberg Community Hospital Family MedicinePowderly, KY, CCN 183478 Rural health clinic Operational/Managerial Control
Other (100%)		 May 1, 2014
Jul 1, 2015
Owensboro Health Twin Lakes Medical Center Family MedicineCaneyville, KY, CCN 188532 Rural health clinic Operational/Managerial Control (100%) Jan 1, 2021

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592784000000",
    "number": "1194149682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PLEASANT VALLEY RD",
            "address_2": "SUITE 104",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423039774",
            "telephone_number": "270-417-6701",
            "fax_number": "270-417-6705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PLEASANT VALLEY RD",
            "address_2": "SUITE 104",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423039774",
            "telephone_number": "270-417-6701",
            "fax_number": "270-417-6705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OWENSBORO HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-05",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A",
        "authorized_official_last_name": "RANALLO",
        "authorized_official_first_name": "RUSS",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCIAL SERVICE",
        "authorized_official_telephone_number": "270-685-7180"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P07614",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Owensboro Health Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Owensboro Health Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.