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General NPI Number Information
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NPI Number | 1982652004
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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 | 05/04/2006
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 1301 NATIONAL HWY
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City | THOMASVILLE
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State | NC
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Zip | 27360-2317
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Country | US
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Telephone | 336-474-1002
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Fax | 336-474-1109
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Provider Business Mailing Address
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Address Line | 2000 FRONTIS PLAZA BLVD STE 102 ATTN: FORSYTH MEDICAL GROUP
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City | WINSTON SALEM
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State | NC
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Zip | 27103-5616
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Country | US
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Telephone | 336-474-1002
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Fax | 336-474-1109
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Authorized Official
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Title or Position | VP OPERATIONS
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Name | MICHELE GRIER
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Credential |
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Telephone | 336-474-1002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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