Healthcare Provider Details

I. General information

NPI: 1932415882
Provider Name (Legal Business Name): APPALACHIAN REGIONAL HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2010
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3004 CUMBERLAND AVENUE SUITE 3
MIDDLESBORO KY
40965
US

IV. Provider business mailing address

3004 CUMBERLAND AVENUE SUITE 3
MIDDLESBORO KY
40965
US

V. Phone/Fax

Practice location:
  • Phone: 606-248-3324
  • Fax:
Mailing address:
  • Phone: 606-248-3324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

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