Provider Demographics
NPI:1073965760
Name:HIGH COUNTRY HOUSE CALL
Entity Type:Organization
Organization Name:HIGH COUNTRY HOUSE CALL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:828-773-7559
Mailing Address - Street 1:1006 S JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28694-9729
Mailing Address - Country:US
Mailing Address - Phone:336-909-4275
Mailing Address - Fax:336-450-1854
Practice Address - Street 1:1006 S JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:WEST JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28694-9729
Practice Address - Country:US
Practice Address - Phone:336-909-4275
Practice Address - Fax:336-450-1854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005546261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center