WINSTON-SALEM STATE UNIVERSITY NPI 1851713374

NPI Information

WINSTON-SALEM STATE UNIVERSITY is a student health clinic center in Winston Salem, NC. WINSTON-SALEM STATE UNIVERSITY NPI is 1851713374. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Wellness Ctr. Student Blue.

The provider's business location address is:

601 S MARTIN LUTHER KING JR DR
A.H. RAY BLDG RM. 244
WINSTON SALEM, NC
ZIP 27110-001
Phone: (336) 750-3301
Fax: (336) 750-3303

The provider's authorized official is Anthony Philadelphia .
The authorized official title is Director and has the following contact phone number (336) 750-3274.

The CLIA number assigned to this NPI record is 34D0904030 - school/student health service with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/17/2014 and was last updated on 1/17/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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