Healthcare Provider Details

I. General information

NPI: 1366449282
Provider Name (Legal Business Name): NORTHERN HOSPITAL OF SURRY COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 ROCKFORD ST
MOUNT AIRY NC
27030-5322
US

IV. Provider business mailing address

PO BOX 1101
MOUNT AIRY NC
27030-1101
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberH0184
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number02362
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RACHEL N HIATT
Title or Position: DIRECTOR, CBO
Credential:
Phone: 336-783-8452