Healthcare Provider Details

I. General information

NPI: 1982530044
Provider Name (Legal Business Name): WAKE FOREST HEALTH NETWORK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 JOHNSON RIDGE MEDICAL PARK
ELKIN NC
28621-2447
US

IV. Provider business mailing address

400 JOHNSON RIDGE MEDICAL PARK
ELKIN NC
28621-2447
US

V. Phone/Fax

Practice location:
  • Phone: 336-526-4500
  • Fax:
Mailing address:
  • Phone: 336-526-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CRAIG MICHAEL GREVEN
Title or Position: SR VP CLINICAL OPERATIONS
Credential: MD
Phone: 336-716-1331