Provider Demographics
NPI:1376822619
Name:APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS
Entity Type:Organization
Organization Name:APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS
Other - Org Name:TALLULAH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHANTELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-202-5200
Mailing Address - Street 1:409 TALLULAH RD
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28771
Mailing Address - Country:US
Mailing Address - Phone:828-479-4039
Mailing Address - Fax:828-479-4980
Practice Address - Street 1:409 TALLULAH RD
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28771
Practice Address - Country:US
Practice Address - Phone:828-479-4039
Practice Address - Fax:828-479-4980
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC110343336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy