Basic Information
Provider Information
NPI: 1568098838
EntityType: 2
ReplacementNPI:  
OrganizationName: APPALACHIAN REGIONAL HEALTHCARE, INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: ARH MEDICAL AND SPECIALTY ASSOCIATES - SALYERSVILLE
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
Address2: SUITE 100
City: SALYERSVILLE
State: KY
PostalCode: 414657525
CountryCode: US
TelephoneNumber: 6063493800
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/19/2020
LastUpdateDate: 05/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
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
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QR1300X  Y Ambulatory Health Care FacilitiesClinic/CenterRural Health

No ID Information.


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