Provider Demographics
NPI:1487702445
Name:FORSYTH MEMORIAL HOSPITAL INC
Entity type:Organization
Organization Name:FORSYTH MEMORIAL HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:B
Authorized Official - Last Name:EVERHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-277-1477
Mailing Address - Street 1:2085 FRONTIS PLAZA BLVD FL 3
Mailing Address - Street 2:FORSYTH MEDICAL GROUP
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5614
Mailing Address - Country:US
Mailing Address - Phone:336-277-1473
Mailing Address - Fax:336-277-9275
Practice Address - Street 1:3333 SILAS CREEK PKWY
Practice Address - Street 2:(DBA) PALLATIVE CARE SERVICES
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3013
Practice Address - Country:US
Practice Address - Phone:336-718-7080
Practice Address - Fax:336-718-9622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty