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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
1207Q00000XFamily Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CA1315OTHERNCRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679531495
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 : 28260-2362
Country : US
Telephone Number : 336-993-8181
Fax Number : 336-996-9539
Provider Business Practice Location Address
First Line : 291 BROAD ST
Second Line :
City : KERNERSVILLE
State : NC
Zip : 27284-2932
Country : US
Telephone Number : 336-993-8181
Fax Number : 336-996-9539
Authorized Official
Title or Position : RCS MANAGER
Name : LEEA JEANINE WALTON
Credential :
Telephone Number : 704-316-6081
Provider Enumeration Date : 05/02/2006
Last Update Date : 07/11/2023

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Directions to “FORSYTH MEMORIAL HOSPITAL, INC ” Practice Location

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