Provider Demographics
NPI:1144355116
Name:FORSYTH COUNTY NORTH CAROLINA
Entity type:Organization
Organization Name:FORSYTH COUNTY NORTH CAROLINA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEPUTY COUNTY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-703-2781
Mailing Address - Street 1:650 HIGHLAND AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-4367
Mailing Address - Country:US
Mailing Address - Phone:336-703-2781
Mailing Address - Fax:
Practice Address - Street 1:650 HIGHLAND AVE STE 140
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-4367
Practice Address - Country:US
Practice Address - Phone:336-703-3250
Practice Address - Fax:336-703-3250
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FORSYTH COUNTY NORTH CAROLINA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-22
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11293336C0002X
261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0345264Medicaid
NC1129OtherFORSYTH CO. HD-PHARMACY