Provider Demographics
NPI:1255120184
Name:WATAUGA MEDICAL CENTER INC
Entity type:Organization
Organization Name:WATAUGA MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CASSADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-262-4119
Mailing Address - Street 1:PO BOX 2600
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-2600
Mailing Address - Country:US
Mailing Address - Phone:828-262-4100
Mailing Address - Fax:
Practice Address - Street 1:336 DEERFIELD RD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5008
Practice Address - Country:US
Practice Address - Phone:828-262-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WATAUGA MEDICAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport