Healthcare Provider Details

I. General information

NPI: 1962040758
Provider Name (Legal Business Name): ARH MARY BRECKINRIDGE HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2019
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 KATE IRELAND DR
HYDEN KY
41749-9071
US

IV. Provider business mailing address

100 AIRPORT GARDENS RD
HAZARD KY
41701-9529
US

V. Phone/Fax

Practice location:
  • Phone: 606-672-2901
  • Fax:
Mailing address:
  • Phone: 606-487-7524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

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