Basic Information
| Provider Information | |||||||||
| NPI: | 1336355601 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | APPALACHIAN REGIONAL HEALTHCARE, INC. | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | ARH WHITESBURG CLINIC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 214 HOSPITAL RD | ||||||||
| Address2: | |||||||||
| City: | WHITESBURG | ||||||||
| State: | KY | ||||||||
| PostalCode: | 418587627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6066333631 | ||||||||
| FaxNumber: | 6064396987 | ||||||||
| Practice Location | |||||||||
| Address1: | 214 HOSPITAL RD | ||||||||
| Address2: | |||||||||
| City: | WHITESBURG | ||||||||
| State: | KY | ||||||||
| PostalCode: | 418587627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6066333631 | ||||||||
| FaxNumber: | 6066336204 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2007 | ||||||||
| LastUpdateDate: | 05/17/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | HARRIS | ||||||||
| AuthorizedOfficialFirstName: | HOLLIE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT AND CEO | ||||||||
| AuthorizedOfficialTelephone: | 8592262511 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 05/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
ID Information
| ID | Type | State | Issuer | Description | 7100350450 | 05 | KY | MEDICAID |