Healthcare Provider Details
I. General information
NPI: 1861283475
Provider Name (Legal Business Name): APPALACHIAN REGIONAL MEDICAL ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
336 DEERFIELD RD
BOONE NC
28607-5008
US
IV. Provider business mailing address
PO BOX 2600
BOONE NC
28607-2600
US
V. Phone/Fax
- Phone: 828-262-4100
- Fax:
- Phone: 828-262-4100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0904X |
| Taxonomy | Nuclear Radiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085U0001X |
| Taxonomy | Diagnostic Ultrasound Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARY
ETTA
LONG
Title or Position: SVP MEDICAL STAFF RELATIONS
Credential:
Phone: 828-262-4133