Healthcare Provider Details
I. General information
NPI: 1669312138
Provider Name (Legal Business Name): HIGH COUNTRY COMMUNITY HEALTH PHARMACY AT WATAUGA BOONE MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
935 STATE FARM RD
BOONE NC
28607-4948
US
IV. Provider business mailing address
PO BOX 1490
BOONE NC
28607-0682
US
V. Phone/Fax
- Phone: 828-262-3886
- Fax:
- Phone: 828-262-3886
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0002X |
| Taxonomy | Clinic Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALICE
SALTHOUSE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 828-262-3886