Provider Demographics
NPI:1306060975
Name:HIGHLANDS HOSPITAL CORP
Entity type:Organization
Organization Name:HIGHLANDS HOSPITAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:C
Authorized Official - Last Name:WARMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:606-886-7600
Mailing Address - Street 1:PO BOX 406
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-0406
Mailing Address - Country:US
Mailing Address - Phone:606-478-8787
Mailing Address - Fax:606-478-4801
Practice Address - Street 1:24 LEFT PENHOOK RD
Practice Address - Street 2:
Practice Address - City:HAROLD
Practice Address - State:KY
Practice Address - Zip Code:41635-7064
Practice Address - Country:US
Practice Address - Phone:606-478-8787
Practice Address - Fax:606-478-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X, 208000000X, 207R00000X, 363L00000X, 363LF0000X, 363A00000X, 363LP2300X
KY900124261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY35001221Medicaid
KY7100234310Medicaid
KY35001221Medicaid
KY7100234310Medicaid
KY183477Medicare Oscar/Certification