Healthcare Provider Details
I. General information
NPI: 1184388555
Provider Name (Legal Business Name): ARH TUG VALLEY HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/22/2021
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
228 CHURCH ST
PAINTSVILLE KY
41240-1012
US
IV. Provider business mailing address
100 AIRPORT GARDENS RD
HAZARD KY
41701-9529
US
V. Phone/Fax
- Phone: 606-788-9100
- Fax:
- Phone: 606-216-5145
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
HOLLIE
HARRIS
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 859-226-2511