Provider Demographics
NPI:1194423855
Name:HIGH COUNTRY COMMUNITY HEALTH
Entity type:Organization
Organization Name:HIGH COUNTRY COMMUNITY HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALTHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-262-3886
Mailing Address - Street 1:PO BOX 1490
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-1490
Mailing Address - Country:US
Mailing Address - Phone:828-262-3886
Mailing Address - Fax:833-665-5329
Practice Address - Street 1:560 MALCOLM BLVD
Practice Address - Street 2:
Practice Address - City:CONNELLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:28612-7918
Practice Address - Country:US
Practice Address - Phone:828-509-5000
Practice Address - Fax:828-509-5100
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIGH COUNTRY COMMUNITY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-21
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy