Healthcare Provider Details
I. General information
NPI: 1144355116
Provider Name (Legal Business Name): FORSYTH COUNTY NORTH CAROLINA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/22/2007
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
650 HIGHLAND AVE STE 140
WINSTON SALEM NC
27101-4367
US
IV. Provider business mailing address
650 HIGHLAND AVE STE 140
WINSTON SALEM NC
27101-4367
US
V. Phone/Fax
- Phone: 336-703-3250
- Fax: 336-703-3250
- Phone: 336-703-2781
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP0905X |
| Taxonomy | State or Local Public Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0002X |
| Taxonomy | Clinic Pharmacy |
| License Number | 1129 |
| License Number State | NC |
VIII. Authorized Official
Name:
DENISE
PRICE
Title or Position: DEPUTY COUNTY MANAGER
Credential:
Phone: 336-703-2781