Provider Demographics
NPI:1346515905
Name:APPALACHIAN REGIONAL HEALTHCARE, INC.
Entity Type:Organization
Organization Name:APPALACHIAN REGIONAL HEALTHCARE, INC.
Other - Org Name:ARH DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MRS
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 1:210 BLACK GOLD BOULEVARD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-2620
Mailing Address - Country:US
Mailing Address - Phone:606-487-7303
Mailing Address - Fax:606-487-7331
Practice Address - Street 1:210 BLACK GOLD BOULEVARD
Practice Address - Street 2:SUITE 211
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-2620
Practice Address - Country:US
Practice Address - Phone:606-487-7303
Practice Address - Fax:606-487-7331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-15
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100221950Medicaid