Healthcare Provider Details

I. General information

NPI: 1407909377
Provider Name (Legal Business Name): WATAUGA MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

358 BEECH ST
NEWLAND NC
28657-0489
US

IV. Provider business mailing address

PO BOX 489
NEWLAND NC
28657-0489
US

V. Phone/Fax

Practice location:
  • Phone: 828-733-1062
  • Fax: 828-733-5831
Mailing address:
  • Phone: 828-733-1062
  • Fax: 828-733-5831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC0826
License Number StateNC

VIII. Authorized Official

Name: MS. LESLIE KIM BIANCA
Title or Position: VP SYSTEM SERVICE LINES
Credential:
Phone: 828-266-1166