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NPI Code Detail

MEDICARE: LIFEBRITE HOSPITAL GROUP OF STOKES, LLC

MEDICARE: LIFEBRITE HOSPITAL GROUP OF STOKES, LLC
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
1282NC0060XCritical Access Hospital
2261QC0050XCritical Access Hospital Clinic/Center

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G557OTHERNCMEDICARE PART B PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2H0165OTHERNCHOSPITAL LICENSURE

General Provider Information

NPI Number : 1548703457
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFEBRITE HOSPITAL GROUP OF STOKES, LLC
Provider Business Mailing Address
First Line : 402 W KING ST
Second Line :
City : KING
State : NC
Zip : 27021-9170
Country : US
Telephone Number : 336-983-9617
Fax Number : 336-983-9791
Provider Business Practice Location Address
First Line : 402 W KING ST
Second Line :
City : KING
State : NC
Zip : 27021-9170
Country : US
Telephone Number : 336-983-9617
Fax Number : 336-983-9791
Authorized Official
Title or Position : CEO
Name : MR. CHRISTIAN FLETCHER
Credential :
Telephone Number : 336-593-5311
Provider Enumeration Date : 11/25/2016
Last Update Date : 09/07/2020

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