Provider Demographics
NPI:1518927334
Name:APPALACHIAN HOSPICE CARE, INC.
Entity Type:Organization
Organization Name:APPALACHIAN HOSPICE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRANHAM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:606-432-2112
Mailing Address - Street 1:1414 S MAYO TRL
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-2206
Mailing Address - Country:US
Mailing Address - Phone:606-432-2112
Mailing Address - Fax:606-432-4631
Practice Address - Street 1:1414 S MAYO TRL
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-2206
Practice Address - Country:US
Practice Address - Phone:606-432-2112
Practice Address - Fax:606-432-4631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
KY400031251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000054875OtherBC/BS
KY070003100OtherBLACK LUNG
KY44098014Medicaid
KY611828OtherWELL CARE
KY2298564OtherCOVENTRY CARES OF KY
KY000000054875OtherBC/BS
KYKYP10000207801OtherKENTUCKY SPIRIT HEALTH PLANS