Healthcare Provider Details
I. General information
NPI: 1184156036
Provider Name (Legal Business Name): ARH MARY BRECKINRIDGE HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/30/2017
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
80 HOSPITAL DR
BARBOURVILLE KY
40906-7363
US
IV. Provider business mailing address
80 HOSPITAL DR
BARBOURVILLE KY
40906-7363
US
V. Phone/Fax
- Phone: 606-545-5500
- Fax: 606-545-5511
- Phone: 606-545-5500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
HOLLIE
HARRIS
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 859-226-2511