1780679332 NPI number — APPALACHIAN REGIONAL HEALTHCARE INC

Table of content: (NPI 1780679332)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780679332 NPI number — APPALACHIAN REGIONAL HEALTHCARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APPALACHIAN REGIONAL HEALTHCARE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BECKLEY ARH HOME HEALTH AGENCY
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780679332
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ARH HOME SERVICES
Provider Second Line Business Mailing Address:
306 MORTON BLVD., SUITE A
Provider Business Mailing Address City Name:
HAZARD
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41701-9418
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-487-6157
Provider Business Mailing Address Fax Number:
606-439-0375

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
306 STANAFORD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BECKLEY
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25801-3142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-255-3373
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HARRIS
Authorized Official First Name:
HOLLIE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT AND CEO
Authorized Official Telephone Number:
859-226-2511

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 001742031 . This is a "MOUNTAIN STATE BC/BS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "BC/BS PROVIDER NUMBER" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "WV WORKERS COMP PROVIDER" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 0001092003 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




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