Healthcare Provider Details

I. General information

NPI: 1114979663
Provider Name (Legal Business Name): FORSYTH MEMORIAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 SILAS CREEK PKWY
WINSTON-SALEM NC
27103-3013
US

IV. Provider business mailing address

2085 FRONTIS PLAZA BLVD
WINSTON-SALEM NC
27103-5614
US

V. Phone/Fax

Practice location:
  • Phone: 336-718-5000
  • Fax:
Mailing address:
  • Phone: 336-277-7226
  • Fax: 336-277-9795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberH0209
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: FRED HARGETT
Title or Position: EVP/CFO
Credential:
Phone: 704-384-5184