Provider Demographics
NPI:1295722189
Name:APPALACHIAN REGIONAL HEALTHCARE, INC.
Entity type:Organization
Organization Name:APPALACHIAN REGIONAL HEALTHCARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:306 MORTON BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9437
Mailing Address - Country:US
Mailing Address - Phone:606-487-6151
Mailing Address - Fax:
Practice Address - Street 1:1217 CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-1160
Practice Address - Country:US
Practice Address - Phone:606-248-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
57327OtherNORTHWOOD/NPN
000000069876OtherANTHEM
048930000OtherFEDERAL BLACK LUNG
TN4581358Medicaid
KY45902509Medicaid
VA9108963Medicaid
KY90030073Medicaid
TN4581358Medicaid