Provider Demographics
NPI:1982602538
Name:HIGH COUNTRY HEALTH CARE SYSTEM
Entity type:Organization
Organization Name:HIGH COUNTRY HEALTH CARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:C
Authorized Official - Last Name:METZGER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:828-264-9155
Mailing Address - Street 1:400 SHADOWLINE DR
Mailing Address - Street 2:SUITE 100 B
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5089
Mailing Address - Country:US
Mailing Address - Phone:828-264-9155
Mailing Address - Fax:828-264-9154
Practice Address - Street 1:400 SHADOWLINE DR
Practice Address - Street 2:SUITE 100 B
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5089
Practice Address - Country:US
Practice Address - Phone:828-264-9155
Practice Address - Fax:828-264-9154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0477251E00000X
NCHC0478251E00000X
NCHC0479251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3417020Medicaid
NC0070TOtherBCBS OF NC
NC347020Medicare PIN