Basic Information
Provider Information
NPI: 1396304044
EntityType: 2
ReplacementNPI:  
OrganizationName: ARH TUG VALLEY HEALTH SERVICES, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ARH MEDICAL AND SPECIALTY ASSOCIATES - SAYLERSVILLE
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 AIRPORT GARDENS RD
Address2:  
City: HAZARD
State: KY
PostalCode: 417019529
CountryCode: US
TelephoneNumber: 6064877524
FaxNumber:  
Practice Location
Address1: 186 BREANNA BLVD STE 100
Address2:  
City: SALYERSVILLE
State: KY
PostalCode: 414657525
CountryCode: US
TelephoneNumber: 6063493800
FaxNumber: 6062635619
Other Information
ProviderEnumerationDate: 06/06/2019
LastUpdateDate: 06/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HARRIS
AuthorizedOfficialFirstName: HOLLIE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT AND CEO
AuthorizedOfficialTelephone: 8592262511
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: APPALACHIAN REGIONAL HELATHCARE, INC.
AuthorizedOfficialNamePrefix: MS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QR1300X  Y Ambulatory Health Care FacilitiesClinic/CenterRural Health

No ID Information.


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