Healthcare Provider Details

I. General information

NPI: 1053983908
Provider Name (Legal Business Name): ARH MARY BRECKINRIDGE HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 CUMBERLAND FALLS HWY
CORBIN KY
40701-2720
US

IV. Provider business mailing address

100 AIRPORT GARDENS RD
HAZARD KY
41701-9529
US

V. Phone/Fax

Practice location:
  • Phone: 606-620-4153
  • Fax: 606-523-3895
Mailing address:
  • Phone: 606-216-5145
  • Fax: 606-439-6927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. HOLLIE P HARRIS
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 859-226-2511