| Pine Ridge Family Practice | |
|
7990 North Point Blvd Winston Salem NC 27106-3259 | |
| (336) 896-1100 | |
| (336) 896-1146 |
| Full Name | Pine Ridge Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 7990 North Point Blvd, Winston Salem, North Carolina |
| Authorized Official Name and Position | Lewis S Thorp (PRESIDENT CEO) |
| Authorized Official Contact | 3367213900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Ridge Family Practice 7990 North Point Blvd Winston Salem NC 27106-3259 Ph: (336) 896-1100 | Pine Ridge Family Practice 7990 North Point Blvd Winston Salem NC 27106-3259 Ph: (336) 896-1100 |
| NPI Number | 1316930654 |
|---|---|
| Provider Enumeration Date | 08/23/2005 |
| Last Update Date | 04/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316930654 | NPI | - | NPPES |
| 2317728H | Other | NC | MEDICARE GROUP NUMBER |
| 890244T | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (North Carolina) | Primary |
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