Healthcare Provider Details
I. General information
NPI: 1326413097
Provider Name (Legal Business Name): ARH MARY BRECKINRIDGE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/07/2015
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
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
- Phone: 606-672-2901
- Fax: 606-672-3626
- Phone: 606-672-2901
- Fax: 606-672-3626
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
HOLLIE
HARRIS
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 859-226-2511