Healthcare Provider Details
I. General information
NPI: 1487727459
Provider Name (Legal Business Name): APPALACHIAN DISTRICT HEALTH DEPT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/16/2006
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
126 POPLAR GROVE CONNECTOR
BOONE NC
28607-5915
US
IV. Provider business mailing address
PO BOX 208
JEFFERSON NC
28640-0208
US
V. Phone/Fax
- Phone: 828-264-4995
- Fax: 828-264-4997
- Phone: 336-246-9449
- Fax: 336-982-3555
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP0905X |
| Taxonomy | State or Local Public Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANIELLE
DOUGHERTY
Title or Position: CREDENTIALER
Credential:
Phone: 336-246-9449