Provider Demographics
NPI:1174016281
Name:ARH MARY BRECKINRIDGE HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:ARH MARY BRECKINRIDGE HEALTH SERVICES, INC.
Other - Org Name:ARH PRIMARY CARE ASSOCIATES - NJ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:HOLLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-226-2511
Mailing Address - Street 1:100 AIRPORT GARDENS RD
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9529
Mailing Address - Country:US
Mailing Address - Phone:606-487-7524
Mailing Address - Fax:606-439-6927
Practice Address - Street 1:12579 MAIN ST
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:KY
Practice Address - Zip Code:41649-7400
Practice Address - Country:US
Practice Address - Phone:606-285-0681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APPALACHIAN REGIONAL HELATHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-13
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health