Provider Demographics
NPI:1407856560
Name:CATAWBA COUNTY DEPARTMENT OF PUBLIC HEALTH
Entity Type:Organization
Organization Name:CATAWBA COUNTY DEPARTMENT OF PUBLIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ISENHOUR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:828-695-5177
Mailing Address - Street 1:3070 11TH AVENUE DR SE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-8336
Mailing Address - Country:US
Mailing Address - Phone:828-695-5800
Mailing Address - Fax:828-695-4410
Practice Address - Street 1:3070 11TH AVENUE DR SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-8336
Practice Address - Country:US
Practice Address - Phone:828-695-5800
Practice Address - Fax:828-695-4410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101793251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3404318Medicaid