Healthcare Provider Details

I. General information

NPI: 1366594665
Provider Name (Legal Business Name): NORTH CAROLINA BAPTIST HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 03/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-1191
US

IV. Provider business mailing address

PO BOX 751730
CHARLOTTE NC
28275-1730
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-3086
  • Fax: 336-716-6203
Mailing address:
  • Phone: 336-716-3539
  • Fax: 336-716-3153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License NumberH0011
License Number StateNC

VIII. Authorized Official

Name: GINA B RAMSEY
Title or Position: VICEPRESIDENT, FINANCIAL MANAGEMENT
Credential:
Phone: 336-716-3005