Basic Information
| Provider Information | |||||||||
| NPI: | 1598429953 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARH TUG VALLEY HEALTH SERVICES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 AIRPORT GARDENS RD | ||||||||
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| City: | HAZARD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 417019529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6062165145 | ||||||||
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| Practice Location | |||||||||
| Address1: | 604 JAMES S. TRIMBLE BOUELVARD | ||||||||
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| City: | PAINTSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 41240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6067893072 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2021 | ||||||||
| LastUpdateDate: | 10/22/2021 | ||||||||
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| AuthorizedOfficialLastName: | HARRIS | ||||||||
| AuthorizedOfficialFirstName: | HOLLIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT AND CEO | ||||||||
| AuthorizedOfficialTelephone: | 8592262511 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | APPALACHIAN REGIONAL HELATHCARE, INC. | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| NPICertificationDate: | 10/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363L00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 261QM1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |
No ID Information.