Healthcare Provider Details

I. General information

NPI: 1386495893
Provider Name (Legal Business Name): NORTHERN HOSPITAL OF SURRY COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N POINTE BLVD
MOUNT AIRY NC
27030-2266
US

IV. Provider business mailing address

PO BOX 1267
MOUNT AIRY NC
27030-1267
US

V. Phone/Fax

Practice location:
  • Phone: 336-789-6267
  • Fax: 336-786-3796
Mailing address:
  • Phone: 336-719-7112
  • Fax: 336-786-3752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RACHEL HIATT
Title or Position: DIRECTOR, CENTRAL BILLING
Credential:
Phone: 336-783-8452