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NPI Code Detail

MEDICARE: FORSYTH MEMORIAL HOSPITAL, INC

MEDICARE: FORSYTH MEMORIAL HOSPITAL, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner
2363A00000XPhysician Assistant
3207Q00000XFamily Medicine Physician
4207R00000XInternal Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CA1315OTHERNCRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285682351
Entity Type Code : Organization
Provider Name (Legal Business Name) : FORSYTH MEMORIAL HOSPITAL, INC
Provider Business Mailing Address
First Line : PO BOX 751803
Second Line :
City : CHARLOTTE
State : NC
Zip : 28275-1803
Country : US
Telephone Number : 336-475-8121
Fax Number : 336-475-5377
Provider Business Practice Location Address
First Line : 309 PINEYWOOD RD
Second Line :
City : THOMASVILLE
State : NC
Zip : 27360-3438
Country : US
Telephone Number : 336-475-8121
Fax Number : 336-475-5377
Authorized Official
Title or Position : RCS MANAGER
Name : LEEA JEANINE WALTON
Credential :
Telephone Number : 704-316-6081
Provider Enumeration Date : 05/04/2006
Last Update Date : 07/12/2023

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Directions to “FORSYTH MEMORIAL HOSPITAL, INC ” Practice Location

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