Healthcare Provider Details

I. General information

NPI: 1043977101
Provider Name (Legal Business Name): APPALACHIAN REGIONAL HEALTHCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2021
Last Update Date: 02/17/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 RITTER DR
GLEN MORGAN WV
25813-7709
US

IV. Provider business mailing address

725 RITTER DR
GLEN MORGAN WV
25813-7709
US

V. Phone/Fax

Practice location:
  • Phone: 304-255-3590
  • Fax: 304-254-9798
Mailing address:
  • Phone: 606-437-1320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

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