Organization
WATAUGA MEDICAL CENTER, INC.
Active
Other names
Outpatient Laboratory, OP Imaging & Lab Center - Wilma Redmont Breast Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY ETTA LONG (SR VP MEDICAL STAFF RELATIONS)
(828) 262-4133
Entity
Organization
Contact information
Practice address
1200 STATE FARM RD, BOONE, NC 28607-4994
(828) 266-2492
(828) 266-2488
Mailing address
336 DEERFIELD RD, BOONE, NC 28607-5008
(828) 262-4100
(828) 262-4103
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
—
—
261QR0206X
Mammography Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
Primary
H0077
NC
Other
Enumeration date
02/20/2015
Last updated
01/08/2025
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