Covered Entity Details

DSH180005C HIGHLANDS ARH REGIONAL MEDICAL CENTER (Active) - information as of 5/26/2025 12:51:27 AM

Main Details

Name

HIGHLANDS ARH REGIONAL MEDICAL CENTER

Subdivision Name

ARH Medical and Specialty Associates - Highlands Urology

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH180005C

Medicare Provider Number

180005

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

10/12/2012

Participating Start Date

1/1/2013

Participating Approval Date

10/26/2012

Last Recertification Date

9/3/2024

Contacts

Authorizing Official

ARH
Maria Braman, Chief Medical Officer
(406) 465-8506

Primary Contact

Appalachian Regional Healthcare, Inc
Michael Herald, Associate Vice President of Pharmaceutical Services
(606) 438-1210

Addresses

Street Address

5000 Ky Route 321
Prestonsburg, KY 41653

Billing Address

Highlands ARH Regional Medical Center - Accounts Payable
200 Hospital Drive
South Williamson, KY 41503

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
KY	7100654350,7100653340,7100651620,7100654210,7100654220,7100654200	1043878325,1063074581,1700445319,1992367569,1285296848,1669123535

Shipping Addresses

Shipping Address 1

Highlands ARH Regional Medical Center
5000 Ky Route 321
Prestonsburg, KY 41653

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH180005A	Child	DSH	HIGHLANDS ARH REGIONAL MEDICAL CENTER	ARH Medical and Specialty Associates - Harold	24 Left Penhook Rd	Harold	KY	Terminated
DSH180005B	Child	DSH	HIGHLANDS REGIONAL MEDICAL CENTER	Highlands Orthopaedic	5000 Ky Route 321	Prestonsburg	KY	Terminated
DSH180005C	Child	DSH	HIGHLANDS ARH REGIONAL MEDICAL CENTER	ARH Medical and Specialty Associates - Highlands Urology	5000 Ky Route 321	Prestonsburg	KY	Active
DSH180005D	Child	DSH	HIGHLANDS ARH REGIONAL MEDICAL CENTER	ARH Medical and Specialty Associates - Salyersville	100 Brianna Blvd.	Salyersville	KY	Terminated
DSH180005E	Child	DSH	HIGHLANDS REGIONAL MEDICAL CENTER	SALYERSVILLE AFTER HOURS	100 Brianna Blvd.	Salyersville	KY	Terminated
DSH180005F	Child	DSH	HIGHLANDS REGIONAL MEDICAL CENTER	ARH Medical and Specialty Associates - Paintsville	713 Broadway	Paintsville	KY	Terminated
DSH180005G	Child	DSH	HIGHLANDS ARH REGIONAL MEDICAL CENTER	ARH Medical and Specialty Associates - Highlands - ORTHOPEDICS	5000 KY Rt. 321	PRESTONSBURG	KY	Active
DSH180005J	Child	DSH	HIGHLANDS ARH REGIONAL MEDICAL CENTER	ARH Medical and Surgical Associates - Highlands Oncology	5000 KY Route 321	Prestonsburg	KY	Active
DSH180005K	Child	DSH	HIGHLANDS ARH REGIONAL MEDICAL CENTER	ARH Medical and Specialty Associates - Highlands - Internal Medicine	5000 KY Route 321	Prestonsburg	KY	Active
DSH180005L	Child	DSH	HIGHLANDS ARH REGIONAL MEDICAL CENTER	ARH Medical and Specialty Associates Highlands - CARDIOLOGY	5000 KY Route 321	Prestonsburg	KY	Active
DSH180005M	Child	DSH	HIGHLANDS ARH REGIONAL MEDICAL CENTER	ARH Medical and Specialty Associates - Highlands - Nephrology	5000 KY Route 321	Prestonsburg	KY	Active
DSH180005N	Child	DSH	HIGHLANDS ARH REGIONAL MEDICAL CENTER	ARH Medical and Specialty Associates - Highlands - Surgery	5000 KY Route 321	Prestonsburg	KY	Active
DSH180005P	Child	DSH	HIGHLANDS ARH REGIONAL MEDICAL CENTER	ARH Medical and Specialty Associates - Highlands - Pulmonology	5000 KY Route 321	Prestonsburg	KY	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/14/2023 2:35:32 PM	9/3/2024 11:20:44 AM	9/3/2024 11:20 AM
Details	Last Recertification Date	Update	Recertification	8/26/2022 11:14:23 AM	8/14/2023 2:35:32 PM	8/14/2023 2:35 PM
Contacts	Authorizing Official	Update	Change Request	Harris, Hollie P President & CEO Appalachian Regional Healthcare, Inc 8592262511	Braman, Maria Chief Medical Officer ARH 4064658506	6/1/2023 7:42 AM
Contacts	Primary Contact	Update	Profile Change Request	Herald, Michael Interim CEO of Pharmaceutical Services Appalachian Regional Healthcare, Inc 6064381210	Herald, Michael Associate Vice President of Pharmaceutical Services Appalachian Regional Healthcare, Inc 6064381210	2/15/2023 3:07 PM
Addresses	Main Address	Update	Change Request	5000 Ky Route 321 Suite 4139 Prestonsburg, KY 41653	5000 Ky Route 321 Prestonsburg, KY 41653	11/22/2022 2:29 PM
Contacts	Primary Contact	Update	Group Change Request	Akers, Jeffrey CEO of Pharmaceutical Services Appalachian Regional Healthcare 6066162296	Herald, Michael Interim CEO of Pharmaceutical Services Appalachian Regional Healthcare, Inc 6064381210	9/13/2022 2:51 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1669123535	8/26/2022 11:14 AM
Medicaid Billing	NPI: State	Insert	Recertification		KY	8/26/2022 11:14 AM
Details	Last Recertification Date	Update	Recertification	9/10/2021 8:19:47 AM	8/26/2022 11:14:23 AM	8/26/2022 11:14 AM
Details	Entity Subname	Update	Change Request	ARH Medical and Surgical Associates - Highlands Urology	ARH Medical and Specialty Associates - Highlands Urology	6/15/2022 8:04 AM
Contacts	Primary Contact	Update	Profile Change Request	Akers, Jeffrey System Director of Pharmacy Appalachian Regional Healthcare 6066162296	Akers, Jeffrey CEO of Pharmaceutical Services Appalachian Regional Healthcare 6066162296	2/8/2022 7:53 PM
Contacts	Authorizing Official	Update	Profile Change Request	Harris, Hollie P President & CEO Appalachian Regional Healthcare, Inc 8592262468	Harris, Hollie P President & CEO Appalachian Regional Healthcare, Inc 8592262511	1/28/2022 9:09 AM
Medicaid Billing	Medicaid: Number	Delete	Change Request	7100041780 (KY)		1/17/2022 12:56 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	7100624230 (KY)		1/17/2022 12:56 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	7100654710 (KY)		1/17/2022 12:56 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	1/17/2022 12:56 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		7100654220	1/17/2022 12:56 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		KY	1/17/2022 12:56 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	1/17/2022 12:56 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		7100654200	1/17/2022 12:56 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		KY	1/17/2022 12:56 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	65926891 (KY)		1/17/2022 12:56 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	7100258270 (KY)		1/17/2022 12:56 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1558415869 (KY)		1/17/2022 12:56 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1689739013 (KY)		1/17/2022 12:56 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1770648107 (KY)		1/17/2022 12:56 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1285296848	1/17/2022 12:56 PM
Medicaid Billing	NPI: State	Insert	Change Request		KY	1/17/2022 12:56 PM
Addresses	Main Address	Update	Recertification	5000 Ky Route 321 Suite 2162 Prestonsburg, KY 41653	5000 Ky Route 321 Suite 4139 Prestonsburg, KY 41653	9/10/2021 8:19 AM
Details	Last Recertification Date	Update	Recertification	8/26/2020 10:45:45 AM	9/10/2021 8:19:47 AM	9/10/2021 8:19 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Group Change Request		False	6/30/2021 5:03 PM
Medicaid Billing	Medicaid: Number	Insert	Group Change Request		7100624230	6/30/2021 5:03 PM
Medicaid Billing	Medicaid: State	Insert	Group Change Request		KY	6/30/2021 5:03 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Group Change Request		False	6/30/2021 5:03 PM
Medicaid Billing	Medicaid: Number	Insert	Group Change Request		7100654710	6/30/2021 5:03 PM
Medicaid Billing	Medicaid: State	Insert	Group Change Request		KY	6/30/2021 5:03 PM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1689739013	6/30/2021 5:03 PM
Medicaid Billing	NPI: State	Insert	Group Change Request		KY	6/30/2021 5:03 PM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1770648107	6/30/2021 5:03 PM
Medicaid Billing	NPI: State	Insert	Group Change Request		KY	6/30/2021 5:03 PM
Contacts	Authorizing Official	Update	Change Request	Grossman, Joseph PRESIDENT and CEO Appalachian Regional Healthcare 8592262450	Harris, Hollie P President & CEO Appalachian Regional Healthcare, Inc 8592262468	5/18/2021 3:07 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/26/2020 10:45 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		7100654350	8/26/2020 10:45 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		KY	8/26/2020 10:45 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/26/2020 10:45 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		7100653340	8/26/2020 10:45 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		KY	8/26/2020 10:45 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/26/2020 10:45 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		7100651620	8/26/2020 10:45 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		KY	8/26/2020 10:45 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/26/2020 10:45 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		7100654210	8/26/2020 10:45 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		KY	8/26/2020 10:45 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1700445319 ( )		8/26/2020 10:45 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1043878325 ( )		8/26/2020 10:45 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1063074581 ( )		8/26/2020 10:45 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1043878325	8/26/2020 10:45 AM
Medicaid Billing	NPI: State	Insert	Recertification		KY	8/26/2020 10:45 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1063074581	8/26/2020 10:45 AM
Medicaid Billing	NPI: State	Insert	Recertification		KY	8/26/2020 10:45 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1558415869	8/26/2020 10:45 AM
Medicaid Billing	NPI: State	Insert	Recertification		KY	8/26/2020 10:45 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1700445319	8/26/2020 10:45 AM
Medicaid Billing	NPI: State	Insert	Recertification		KY	8/26/2020 10:45 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1992367569	8/26/2020 10:45 AM
Medicaid Billing	NPI: State	Insert	Recertification		KY	8/26/2020 10:45 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1558415869 ( )		8/26/2020 10:45 AM
Details	Last Recertification Date	Update	Recertification	9/4/2019 10:42:11 AM	8/26/2020 10:45:45 AM	8/26/2020 10:45 AM
Contacts	Primary Contact	Update	Profile Change Request	Akers, Jeffrey System Director of Pharmacy Appalachian Regional Healthcare 6064396988	Akers, Jeffrey System Director of Pharmacy Appalachian Regional Healthcare 6066162296	1/8/2020 11:00 AM
Details	Last Recertification Date	Update	Recertification	9/10/2018 10:04:05 AM	9/4/2019 10:42:11 AM	9/4/2019 10:42 AM
Details	Entity Name	Update	Change Request	HIGHLANDS REGIONAL MEDICAL CENTER	HIGHLANDS ARH REGIONAL MEDICAL CENTER	8/8/2019 7:21 AM
Addresses	Billing Address	Insert	Change Request		Highlands ARH Regional Medical Center - Accounts Payable 200 Hospital Drive South Williamson, KY 41503	8/8/2019 7:20 AM
Addresses	Shipping Address	Insert	Change Request		Highlands ARH Regional Medical Center 5000 Ky Route 321 Prestonsburg, KY 41653	8/8/2019 7:20 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	8/8/2019 7:20 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		7100041780	8/8/2019 7:20 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		KY	8/8/2019 7:20 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1043878325	8/8/2019 7:20 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1063074581	8/8/2019 7:20 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1700445319	8/5/2019 3:55 PM
Contacts	Primary Contact	Update	Change Request	Howard, Vylinda Director of Pharmacy Services Highlands Regional Medical Center 6068867617	Akers, Jeffrey System Director of Pharmacy Appalachian Regional Healthcare 6064396988	8/5/2019 3:55 PM
Details	Entity Subname	Update	Change Request	Highlands Urology	ARH Medical and Surgical Associates - Highlands Urology	8/5/2019 3:55 PM
Contacts	Authorizing Official	Update	AO Change Request	Warman Jr., Harold C. CEO Highlands Regional Medical Center 6068867602	Grossman, Joseph PRESIDENT and CEO Appalachian Regional Healthcare 8592262450	8/1/2019 1:41 PM
Details	Last Recertification Date	Update	Recertification	11/9/2017 8:35:41 AM	9/10/2018 10:04:05 AM	9/10/2018 10:04 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/23/2018 9:43 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		7100258270	7/23/2018 9:43 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		KY	7/23/2018 9:43 AM
Details	Last Recertification Date	Update	Recertification	9/1/2016 12:00:00 AM	11/9/2017 8:35:41 AM	11/9/2017 8:35 AM
Contacts	Authorizing Official	Update		Warman Jr., Harold C. CEO 6068867602	Warman Jr., Harold C. CEO Highlands Regional Medical Center 6068867602	10/16/2017 3:31 PM
Contacts	Primary Contact	Update		Howard, Vylinda Director of Pharmacy Services 6068867617	Howard, Vylinda Director of Pharmacy Services Highlands Regional Medical Center 6068867617	10/16/2017 2:41 PM
Contacts	Signed By	Insert			BLACKWELL, JACK CFO 6068868511	6/15/2017 2:22 PM
Contacts	Authorizing Official	Insert			Warman Jr., Harold C. CEO 6068867602	6/15/2017 2:22 PM
Contacts	Primary Contact	Insert			Howard, Vylinda Director of Pharmacy Services 6068867617	6/15/2017 2:21 PM
Addresses	Main Address	Insert			5000 Ky Route 321 Suite 2162 Prestonsburg, KY 41653	6/15/2017 2:21 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	9/1/2016 8:18 AM
Medicaid Billing	Medicaid: Number	Insert			65926891	9/1/2016 8:18 AM
Medicaid Billing	Medicaid: State	Insert			KY	9/1/2016 8:18 AM
Medicaid Billing	NPI: Number	Insert			1558415869	9/1/2016 8:18 AM
Details	Last Recertification Date	Update		9/1/2015 12:00:00 AM	9/1/2016 12:00:00 AM	9/1/2016 8:18 AM
Details	Last Recertification Date	Update		8/21/2014 12:00:00 AM	9/1/2015 12:00:00 AM	9/1/2015 4:36 PM
Details	Last Recertification Date	Update		8/19/2013 12:00:00 AM	8/21/2014 12:00:00 AM	8/21/2014 1:01 PM
Details	Last Recertification Date	Update			8/19/2013 12:00:00 AM	8/19/2013 3:08 PM
Details	340B ID	Update		IS-AP-DSH180005C	DSH180005C	10/26/2012 4:24 PM
Dates	Participating Approval Date	Update			10/26/2012 12:00:00 AM	10/26/2012 4:24 PM
Details	State	Update		Pending	Active	10/26/2012 4:24 PM
Dates	Start Date	Update			1/1/2013 12:00:00 AM	10/26/2012 4:24 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG	IS-AP-DSH180005C	10/26/2012 2:16 PM
Details	Last Recertification Date	Insert				10/12/2012 2:50 PM
Details	Grant Number	Insert				10/12/2012 2:50 PM
Details	340B ID	Insert			OUTPATIENT_ONLINE_REG	10/12/2012 2:50 PM
Details	Is Authorizing Official EHB Data	Insert				10/12/2012 2:50 PM
Dates	Last Date That 340B Drugs Purchased	Insert				10/12/2012 2:50 PM
Details	Medicare Provider Number	Insert			180005	10/12/2012 2:50 PM
Details	Entity Name	Insert			HIGHLANDS REGIONAL MEDICAL CENTER	10/12/2012 2:50 PM
Details	Program Code	Insert			DSH	10/12/2012 2:50 PM
Details	Entity Subname	Insert			Highlands Urology	10/12/2012 2:50 PM
Dates	Participating Approval Date	Insert				10/12/2012 2:50 PM
Details	State	Insert			Pending	10/12/2012 2:50 PM
Dates	Registration Date	Insert			10/12/2012 12:00:00 AM	10/12/2012 2:50 PM
Dates	Signed By Date	Insert			10/12/2012 12:00:00 AM	10/12/2012 2:50 PM
Dates	Start Date	Insert				10/12/2012 2:50 PM
Terminations	Termination Comments	Insert				10/12/2012 2:50 PM
Terminations	Termination Date	Insert				10/12/2012 2:50 PM
Terminations	Termination Effective Date	Insert				10/12/2012 2:50 PM
Terminations	Termination Reason	Insert				10/12/2012 2:50 PM