Healthcare Provider Details

I. General information

NPI: 1689849200
Provider Name (Legal Business Name): NORTH CAROLINA BAPTIST HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2008
Last Update Date: 04/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-0001
US

IV. Provider business mailing address

PO BOX 751730
CHARLOTTE NC
28275-1730
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-3103
  • Fax: 336-716-7300
Mailing address:
  • Phone: 336-716-3103
  • Fax: 336-716-7300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberH0011
License Number StateNC

VIII. Authorized Official

Name: MS. DONNY C LAMBETH
Title or Position: PRESIDENT
Credential:
Phone: 336-716-3003