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NPI 1134038367

NPI 1134038367 : FORSYTH MEMORIAL HOSPITAL, INC. : YADKINVILLE, NC

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General NPI Number Information
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    NPI Number           |    1134038367
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    Entity Type          |    Organization 
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    Legal Business Name  |    FORSYTH MEMORIAL HOSPITAL, INC. 
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Dates
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    Enumeration Date     |    09/03/2026
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    Last Update Date     |    09/03/2026
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Provider Practice Location Address
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    Address Line         |    305 E LEE AVE 
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    City                 |    YADKINVILLE
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    State                |    NC
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    Zip                  |    27055-8132
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    Country              |    US
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    Telephone            |    704-000-0000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 751803 
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    City                 |    CHARLOTTE
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    State                |    NC
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    Zip                  |    28275-1803
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    RCS MANAGER
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    Name                 |     LEEA JEANINE WALTON 
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    Credential           |    
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    Telephone            |    704-316-6081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2084S0012X
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    Taxonomy Name        |    Sleep Medicine (Psychiatry & Neurology) Physician
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    License Number       |    
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    License Number State |    
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