Provider Demographics
NPI:1043781990
Name:WAKE FOREST UNIVERSITY HEALTH SCIENCES
Entity Type:Organization
Organization Name:WAKE FOREST UNIVERSITY HEALTH SCIENCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, HEALTH SYSTEM, WFBH
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:HIGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-716-8021
Mailing Address - Street 1:100 KIMEL FOREST DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6074
Mailing Address - Country:US
Mailing Address - Phone:336-713-9329
Mailing Address - Fax:336-716-3202
Practice Address - Street 1:225 W WARD ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5423
Practice Address - Country:US
Practice Address - Phone:336-625-3338
Practice Address - Fax:336-625-1563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies