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NPI Code Detail

MEDICARE: SCHOOL HEALTH ALLIANCE FOR FORSYTH COUNTY

MEDICARE: SCHOOL HEALTH ALLIANCE FOR FORSYTH COUNTY
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
1261QS1000XStudent Health Clinic/Center

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 : 1831439637
Entity Type Code : Organization
Provider Name (Legal Business Name) : SCHOOL HEALTH ALLIANCE FOR FORSYTH COUNTY
Provider Business Mailing Address
First Line : 1 MEDICAL CENTER BLVD
Second Line : WFBH ATTN: TRACY BRADSHAW
City : WINSTON SALEM
State : NC
Zip : 27157-0001
Country : US
Telephone Number : 336-713-7188
Fax Number : 336-713-7183
Provider Business Practice Location Address
First Line : 4555 OGBURN AVE
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27105-2726
Country : US
Telephone Number : 336-661-4952
Fax Number : 336-661-4954
Authorized Official
Title or Position : PRACTICE MANAGER
Name : MRS. TRACY BRADSHAW
Credential :
Telephone Number : 336-713-7188
Provider Enumeration Date : 02/15/2013
Last Update Date : 02/15/2013

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Directions to “SCHOOL HEALTH ALLIANCE FOR FORSYTH COUNTY ” Practice Location

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