Provider Demographics
NPI:1932328192
Name:NORTH CAROLINA BAPTIST HOSPITAL
Entity Type:Organization
Organization Name:NORTH CAROLINA BAPTIST HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCHOMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, BCPS
Authorized Official - Phone:336-713-3421
Mailing Address - Street 1:MEDICAL CENTER BLVD
Mailing Address - Street 2:NORTH TOWER PHARMACY
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-716-3363
Mailing Address - Fax:336-716-9263
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-716-3363
Practice Address - Fax:336-716-9263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336S0011X
NC008193336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC345272Medicaid
2067632OtherPK