Provider Demographics
NPI:1285799080
Name:ASHLAND-BELLEFONTE CARDIOLOGY, PSC
Entity type:Organization
Organization Name:ASHLAND-BELLEFONTE CARDIOLOGY, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:MILTON
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-836-9613
Mailing Address - Street 1:800 SAINT CHRISTOPHER DR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7030
Mailing Address - Country:US
Mailing Address - Phone:606-836-9613
Mailing Address - Fax:606-836-0026
Practice Address - Street 1:800 SAINT CHRISTOPHER DR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7030
Practice Address - Country:US
Practice Address - Phone:606-836-9613
Practice Address - Fax:606-836-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810006604Medicaid
OH0104676Medicaid
WV3810006604Medicaid
KY8201Medicare ID - Type UnspecifiedGROUP NUMBER FOR MEDICARE