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NPI Code Detail

MEDICARE: LUTHERAN HOME-WINSTON-SALEM, INC.

MEDICARE: LUTHERAN HOME-WINSTON-SALEM, INC.
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
1314000000XSkilled Nursing FacilityNH0058NC

Other Identifiers

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

General Provider Information

NPI Number : 1912902230
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUTHERAN HOME-WINSTON-SALEM, INC.
Provider Business Mailing Address
First Line : 5350 OLD WALKERTOWN RD
Second Line :
City : WINSTON-SALEM
State : NC
Zip : 27105-2060
Country : US
Telephone Number : 336-595-2166
Fax Number : 336-595-2169
Provider Business Practice Location Address
First Line : 849 WATERWORKS RD
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27101-1956
Country : US
Telephone Number : 336-595-2166
Fax Number : 336-595-2169
Authorized Official
Title or Position : PRESIDENT
Name : TED GOINS
Credential :
Telephone Number : 704-637-2870
Provider Enumeration Date : 06/14/2005
Last Update Date : 02/04/2026

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