Healthcare Provider Details

I. General information

NPI: 1528553757
Provider Name (Legal Business Name): APPALACHIAN REGIONAL HEALTHCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2018
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2004 CUMBERLAND AVE STE 100
MIDDLESBORO KY
40965-1385
US

IV. Provider business mailing address

100 AIRPORT GARDENS RD
HAZARD KY
41701-9529
US

V. Phone/Fax

Practice location:
  • Phone: 606-248-3015
  • Fax: 606-248-3024
Mailing address:
  • Phone: 606-487-7524
  • Fax: 606-439-6927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number900344
License Number StateKY

VIII. Authorized Official

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