Healthcare Provider Details

I. General information

NPI: 1770006355
Provider Name (Legal Business Name): HIGH COUNTRY COMMUNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2017
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 ROCKFORD ST
MOUNT AIRY NC
27030-5323
US

IV. Provider business mailing address

PO BOX 1490
BOONE NC
28607-0682
US

V. Phone/Fax

Practice location:
  • Phone: 336-648-8058
  • Fax:
Mailing address:
  • Phone: 828-262-3886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number05647
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ALICE SALTHOUSE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 828-262-3886