Healthcare Provider Details

I. General information

NPI: 1356896187
Provider Name (Legal Business Name): APPALACHIAN MOUNTAIN COMMUNITY HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2016
Last Update Date: 04/09/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4226 E US HIGHWAY 64-ALT
MURPHY NC
28906-6966
US

IV. Provider business mailing address

PO BOX 100181
COLUMBIA SC
29202-3141
US

V. Phone/Fax

Practice location:
  • Phone: 828-479-6434
  • Fax: 828-479-2917
Mailing address:
  • Phone: 828-202-5200
  • Fax: 828-479-2917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: SHANTELLE SIMPSON
Title or Position: PRESIDENT & CHIEF EXECUTIVE OFFICER
Credential:
Phone: 828-202-5200