MEDICARE: CATAWBA COUNTY DEPARTMENT OF PUBLIC HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency	101793	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407856560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATAWBA COUNTY DEPARTMENT OF PUBLIC HEALTH

Provider Business Mailing Address
First Line	:	3070 11TH AVENUE DR SE
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28602-8336
Country	:	US
Telephone Number	:	828-695-5800
Fax Number	:	828-695-4410

Provider Business Practice Location Address
First Line	:	3070 11TH AVENUE DR SE
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28602-8336
Country	:	US
Telephone Number	:	828-695-5800
Fax Number	:	828-695-4410

Authorized Official
Title or Position	:	ASSISTANT HEALTH DIRECTOR
Name	:	MRS. KELLY ISENHOUR
Credential	:	R.N.
Telephone Number	:	828-695-5177

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	08/22/2020

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1528133733 — COUNTY OF CATAWBA OFFICE OF ACCOUNTANT
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Directions to “CATAWBA COUNTY DEPARTMENT OF PUBLIC HEALTH ” Practice Location

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