Healthcare Provider Details

I. General information

NPI: 1740382795
Provider Name (Legal Business Name): APPALACHIAN REGIONAL HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3602 WEST CUMBERLAND AVENUE
MIDDLESBORO KY
40965-0340
US

IV. Provider business mailing address

3602 WEST CUMBERLAND AVENUE
MIDDLESBORO KY
40965-0340
US

V. Phone/Fax

Practice location:
  • Phone: 606-242-1463
  • Fax: 606-242-1111
Mailing address:
  • Phone: 606-242-1463
  • Fax: 606-242-1111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number10019
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

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