Healthcare Provider Details

I. General information

NPI: 1649713462
Provider Name (Legal Business Name): LIFEBRITE HOSPITAL GROUP OF STOKES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 03/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 MOORE RD
KING NC
27021-8770
US

IV. Provider business mailing address

167 MOORE RD
KING NC
27021-8770
US

V. Phone/Fax

Practice location:
  • Phone: 336-983-6898
  • Fax: 336-983-6921
Mailing address:
  • Phone: 336-983-6898
  • Fax: 336-983-6921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIAN FLETCHER
Title or Position: CEO
Credential:
Phone: 336-593-5311