Provider Demographics
NPI:1881460855
Name:NORTH CAROLINA BAPTIST HOSPITAL
Entity type:Organization
Organization Name:NORTH CAROLINA BAPTIST HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-713-3421
Mailing Address - Street 1:PO BOX 602078
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2078
Mailing Address - Country:US
Mailing Address - Phone:336-713-7785
Mailing Address - Fax:336-702-9190
Practice Address - Street 1:2295 E 14TH ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27105-6804
Practice Address - Country:US
Practice Address - Phone:336-716-0888
Practice Address - Fax:336-716-0840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy