1689114969 NPI number — NORTHERN HOSPITAL OF SURRY COUNTY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689114969 NPI number — NORTHERN HOSPITAL OF SURRY COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHERN HOSPITAL OF SURRY COUNTY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689114969
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1267
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNT AIRY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27030-1267
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-783-8911
Provider Business Mailing Address Fax Number:
336-719-2492

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
314 S SOUTH ST STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT AIRY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27030-4491
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-719-0011
Provider Business Practice Location Address Fax Number:
336-719-0714
Provider Enumeration Date:
03/06/2017

Additional Information

Authorized Official

Authorized Official Last Name:
ALLEN
Authorized Official First Name:
ROBIN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR CENTRAL BILLING
Authorized Official Telephone Number:
336-719-7129

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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