Provider Demographics
NPI:1295278174
Name:LIFEBRITE HOSPITAL GROUP OF STOKES, LLC
Entity type:Organization
Organization Name:LIFEBRITE HOSPITAL GROUP OF STOKES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-593-5311
Mailing Address - Street 1:167 MOORE RD
Mailing Address - Street 2:
Mailing Address - City:KING
Mailing Address - State:NC
Mailing Address - Zip Code:27021-8770
Mailing Address - Country:US
Mailing Address - Phone:336-985-2140
Mailing Address - Fax:336-983-2172
Practice Address - Street 1:167 MOORE RD
Practice Address - Street 2:
Practice Address - City:KING
Practice Address - State:NC
Practice Address - Zip Code:27021-8770
Practice Address - Country:US
Practice Address - Phone:336-985-2140
Practice Address - Fax:336-983-2172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-28
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG557OtherMEDICARE PART B PTAN
NCH0165OtherHOSPITAL LICENSURE