Healthcare Provider Details
I. General information
NPI: 1225070675
Provider Name (Legal Business Name): STOKES REYNOLDS MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/11/2006
Last Update Date: 06/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1570 NC 8&89 HWY NORTH
DANBURY NC
27016-0010
US
IV. Provider business mailing address
PO BOX 10
DANBURY NC
27016-0010
US
V. Phone/Fax
- Phone: 336-593-5329
- Fax: 336-593-5327
- Phone: 336-593-5329
- Fax: 336-593-5327
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336I0012X |
| Taxonomy | Institutional Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | 05468 |
| License Number State | NC |
VIII. Authorized Official
Name:
MIRIAM
STAFFORD
Title or Position: PHARMACY MANAGER
Credential: RPH
Phone: 336-593-5329