Healthcare Provider Details

I. General information

NPI: 1053497263
Provider Name (Legal Business Name): WHITESBURG APPALACHIAN REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 HOSPITAL RD
WHITESBURG KY
41858-7627
US

IV. Provider business mailing address

240 HOSPITAL RD
WHITESBURG KY
41858-7627
US

V. Phone/Fax

Practice location:
  • Phone: 606-633-3500
  • Fax: 606-633-3652
Mailing address:
  • Phone: 606-633-3500
  • Fax: 606-633-3652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number100288
License Number StateKY

VIII. Authorized Official

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