=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518927334
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | APPALACHIAN HOSPICE CARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/24/2006
-----------------------------------------------------
Last Update Date | 12/07/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1414 S MAYO TRL
-----------------------------------------------------
City | PIKEVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41501-2206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-432-2112
-----------------------------------------------------
Fax | 606-432-4631
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1414 S MAYO TRL
-----------------------------------------------------
City | PIKEVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41501-2206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-432-2112
-----------------------------------------------------
Fax | 606-432-4631
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRES/CEO
-----------------------------------------------------
Name | MS. SHARON A. BRANHAM
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 606-432-2112
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number | 400031
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------