Healthcare Provider Details

I. General information

NPI: 1033159744
Provider Name (Legal Business Name): STOKES REYNOLDS MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 03/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1570 NC 8 AND 89 HWY N
DANBURY NC
27016-7360
US

IV. Provider business mailing address

1570 NC 8 AND 89 HWY N
DANBURY NC
27016-7360
US

V. Phone/Fax

Practice location:
  • Phone: 336-593-2831
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberHO165
License Number StateNC

VIII. Authorized Official

Name: PAMELA P. TILLMAN
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 336-593-5314