Healthcare Provider Details

I. General information

NPI: 1215180260
Provider Name (Legal Business Name): APPALACHIAN REGIONAL HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2008
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 BLACK GOLD BLVD SUITE 104
HAZARD KY
41701-2620
US

IV. Provider business mailing address

PO BOX 602
WEST LIBERTY KY
41472
US

V. Phone/Fax

Practice location:
  • Phone: 606-487-7380
  • Fax: 606-487-7384
Mailing address:
  • Phone: 606-743-2033
  • Fax: 606-743-2943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP07283
License Number StateKY

VIII. Authorized Official

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