Healthcare Provider Details

I. General information

NPI: 1114192358
Provider Name (Legal Business Name): NORTH CAROLINA BAPTIST HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDICAL CENTER BLVD NORTH TOWER GROUND FLOOR
WINSTON SALEM NC
27157-0001
US

IV. Provider business mailing address

NC BAPTIST HOSPITAL SPECIALTY RX MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-0001
US

V. Phone/Fax

Practice location:
  • Phone: 336-713-7776
  • Fax: 336-713-7783
Mailing address:
  • Phone: 336-713-8064
  • Fax: 336-713-7783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number17329
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number10039
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number0214001868
License Number StateVA

VIII. Authorized Official

Name: REGINA H SCHOMBERG
Title or Position: DIRECTOR OF PHARMACY
Credential: PHARMD, BCPS
Phone: 336-713-3421