Details | Last Recertification Date | Update | Recertification | 8/14/2023 1:21:37 PM | 9/3/2024 11:15:29 AM | 9/3/2024 11:15 AM |
Details | Last Recertification Date | Update | Recertification | 8/26/2022 11:15:22 AM | 8/14/2023 1:21:37 PM | 8/14/2023 1:21 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 Rt. 321
Suite 2127
PRESTONSBURG, KY 41653 |
5000 KY Rt. 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 11:15 AM |
Medicaid Billing | NPI: State | Insert | Recertification | | KY | 8/26/2022 11:15 AM |
Details | Last Recertification Date | Update | Recertification | 9/9/2021 10:19:43 AM | 8/26/2022 11:15:22 AM | 8/26/2022 11:15 AM |
Details | Entity Subname | Update | Change Request | ARH Medical and Surgical Associates - Highlands - ORTHOPEDICS | ARH Medical and Specialty Associates - Highlands - ORTHOPEDICS | 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 | 1558527903 (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 |
Details | Last Recertification Date | Update | Recertification | 8/26/2020 10:48:40 AM | 9/9/2021 10:19:43 AM | 9/9/2021 10:19 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 10:48 AM |
Medicaid Billing | Medicaid: Number | Insert | Recertification | | 7100654210 | 8/26/2020 10:48 AM |
Medicaid Billing | Medicaid: State | Insert | Recertification | | KY | 8/26/2020 10:48 AM |
Medicaid Billing | Medicaid: Is Primary | Insert | Recertification | | False | 8/26/2020 10:48 AM |
Medicaid Billing | Medicaid: Number | Insert | Recertification | | 7100654350 | 8/26/2020 10:48 AM |
Medicaid Billing | Medicaid: State | Insert | Recertification | | KY | 8/26/2020 10:48 AM |
Medicaid Billing | Medicaid: Is Primary | Insert | Recertification | | False | 8/26/2020 10:48 AM |
Medicaid Billing | Medicaid: Number | Insert | Recertification | | 7100653340 | 8/26/2020 10:48 AM |
Medicaid Billing | Medicaid: State | Insert | Recertification | | KY | 8/26/2020 10:48 AM |
Medicaid Billing | Medicaid: Is Primary | Insert | Recertification | | False | 8/26/2020 10:48 AM |
Medicaid Billing | Medicaid: Number | Insert | Recertification | | 7100651620 | 8/26/2020 10:48 AM |
Medicaid Billing | Medicaid: State | Insert | Recertification | | KY | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1043878325 ( ) | | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1063074581 ( ) | | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1700445319 ( ) | | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1043878325 | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: State | Insert | Recertification | | KY | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1063074581 | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: State | Insert | Recertification | | KY | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1558415869 | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: State | Insert | Recertification | | KY | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1558527903 | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: State | Insert | Recertification | | KY | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1700445319 | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: State | Insert | Recertification | | KY | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1992367569 | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: State | Insert | Recertification | | KY | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1558527903 ( ) | | 8/26/2020 10:48 AM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1558415869 ( ) | | 8/26/2020 10:48 AM |
Details | Last Recertification Date | Update | Recertification | 9/4/2019 10:43:24 AM | 8/26/2020 10:48:40 AM | 8/26/2020 10:48 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 11:04:14 AM | 9/4/2019 10:43:24 AM | 9/4/2019 10:43 AM |
Details | Entity Name | Update | Change Request | HIGHLANDS REGIONAL MEDICAL CENTER | HIGHLANDS ARH REGIONAL MEDICAL CENTER | 8/8/2019 7:21 AM |
Medicaid Billing | Medicaid: Is Primary | Insert | Change Request | | False | 8/6/2019 9:17 AM |
Medicaid Billing | Medicaid: Number | Insert | Change Request | | 7100041780 | 8/6/2019 9:17 AM |
Medicaid Billing | Medicaid: State | Insert | Change Request | | KY | 8/6/2019 9:17 AM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1043878325 | 8/6/2019 9:17 AM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1063074581 | 8/6/2019 9:17 AM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1700445319 | 8/6/2019 9:17 AM |
Addresses | Billing Address | Insert | Change Request | | Highlands ARH Regional Medical Center - ACCOUNTS PAYABLE
200 HOSPITAL DRIVE
South Williamson, KY 41503 | 8/5/2019 3:58 PM |
Addresses | Shipping Address | Insert | Change Request | | Highlands ARH Regional Medical Center
5000 KY Rt 321
Prestonsburg, KY 41653 | 8/5/2019 3:58 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 3:58 PM |
Details | Entity Subname | Update | Change Request | HIGHLANDS ORTHOPAEDICS II | ARH Medical and Surgical Associates - Highlands - ORTHOPEDICS | 8/5/2019 3:58 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 |
Addresses | Main Address | Update | Recertification |
5000 KY Rt. 321
Suite 4139
PRESTONSBURG, KY 41653 |
5000 KY Rt. 321
Suite 2127
PRESTONSBURG, KY 41653 | 9/10/2018 11:04 AM |
Details | Last Recertification Date | Update | Recertification | 11/9/2017 8:26:08 AM | 9/10/2018 11:04:14 AM | 9/10/2018 11:04 AM |
Medicaid Billing | Medicaid: Is Primary | Insert | Change Request | | False | 7/23/2018 9:42 AM |
Medicaid Billing | Medicaid: Number | Insert | Change Request | | 7100258270 | 7/23/2018 9:42 AM |
Medicaid Billing | Medicaid: State | Insert | Change Request | | KY | 7/23/2018 9:42 AM |
Medicaid Billing | NPI: Number | Insert | Change Request | | 1558415869 | 7/23/2018 9:42 AM |
Contacts | Primary Contact | Update | Change Request | HOWARD, VYLINDA
DIRECTOR OF PHARMACY
HIGHLANDS REGIONAL MEDICAL CENTER
6068867617 | Howard, Vylinda
Director of Pharmacy Services
Highlands Regional Medical Center
6068867617 | 7/23/2018 9:42 AM |
Details | Last Recertification Date | Update | Recertification | 9/1/2016 12:00:00 AM | 11/9/2017 8:26:08 AM | 11/9/2017 8:26 AM |
Contacts | Primary Contact | Update | Recertification | HOWARD, VYLINDA
DIRECTOR OF PHARMACY
6068867617 | HOWARD, VYLINDA
DIRECTOR OF PHARMACY
HIGHLANDS REGIONAL MEDICAL CENTER
6068867617 | 11/9/2017 8:26 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 |
Addresses | Main Address | Insert | | |
5000 KY Rt. 321
Suite 4139
PRESTONSBURG, KY 41653 | 6/15/2017 2:22 PM |
Contacts | Signed By | Insert | | | BLACKWELL, JACK
CFO
6068868511 | 6/15/2017 2:22 PM |
Contacts | Primary Contact | Insert | | | HOWARD, VYLINDA
DIRECTOR OF PHARMACY
6068867617 | 6/15/2017 2:22 PM |
Contacts | Authorizing Official | Insert | | | Warman Jr., Harold C.
CEO
6068867602 | 6/15/2017 2:22 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 | | | 1558527903 | 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 | | | 8/21/2014 12:00:00 AM | 8/21/2014 1:01 PM |
Dates | Participating Approval Date | Update | | | 12/9/2013 12:00:00 AM | 12/9/2013 3:27 PM |
Details | State | Update | | Pending | Active | 12/9/2013 3:27 PM |
Dates | Start Date | Update | | | 1/1/2014 12:00:00 AM | 12/9/2013 3:27 PM |
Details | 340B ID | Update | | OUTPATIENT_ONLINE_REG | DSH180005G | 11/14/2013 4:11 PM |
Details | Last Recertification Date | Insert | | | | 10/14/2013 1:43 PM |
Details | Grant Number | Insert | | | | 10/14/2013 1:43 PM |
Details | 340B ID | Insert | | | OUTPATIENT_ONLINE_REG | 10/14/2013 1:43 PM |
Details | Is Authorizing Official EHB Data | Insert | | | | 10/14/2013 1:43 PM |
Dates | Last Date That 340B Drugs Purchased | Insert | | | | 10/14/2013 1:43 PM |
Details | Medicare Provider Number | Insert | | | 180005 | 10/14/2013 1:43 PM |
Details | Entity Name | Insert | | | HIGHLANDS REGIONAL MEDICAL CENTER | 10/14/2013 1:43 PM |
Details | Program Code | Insert | | | DSH | 10/14/2013 1:43 PM |
Details | Entity Subname | Insert | | | HIGHLANDS ORTHOPAEDICS II | 10/14/2013 1:43 PM |
Dates | Participating Approval Date | Insert | | | | 10/14/2013 1:43 PM |
Details | State | Insert | | | Pending | 10/14/2013 1:43 PM |
Dates | Registration Date | Insert | | | 10/14/2013 12:00:00 AM | 10/14/2013 1:43 PM |
Dates | Signed By Date | Insert | | | 10/14/2013 12:00:00 AM | 10/14/2013 1:43 PM |
Dates | Start Date | Insert | | | | 10/14/2013 1:43 PM |
Terminations | Termination Comments | Insert | | | | 10/14/2013 1:43 PM |
Terminations | Termination Date | Insert | | | | 10/14/2013 1:43 PM |
Terminations | Termination Effective Date | Insert | | | | 10/14/2013 1:43 PM |
Terminations | Termination Reason | Insert | | | | 10/14/2013 1:43 PM |