=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891792495
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | APPALACHIAN REGIONAL HEALTHCARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/28/2005
-----------------------------------------------------
Last Update Date | 09/20/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3600 CUMBERLAND AVE
-----------------------------------------------------
City | MIDDLESBORO
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40965-2614
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-242-1100
-----------------------------------------------------
Fax | 606-242-1111
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3600 CUMBERLAND AVE
-----------------------------------------------------
City | MIDDLESBORO
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40965-2614
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-242-1100
-----------------------------------------------------
Fax | 606-242-1111
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT AND CEO
-----------------------------------------------------
Name | MRS. HOLLIE HARRIS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 859-226-2511
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | 100019
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------