Organization Name: | WAKE FOREST UNIVERSITY STUDENT HEALTH SERVICE |
NPI Number: | 1053452953 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CECIL DWIGHT PRICE (DIRECTOR) |
Mailing Address: | 1834 Reynolda Road Mackie Health Center - Reynolds Gym - Wingate Rd. Wfu Winston-salem |
State: | NC US |
Postal Code: | 27106 |
Phone Number: | 3367585218 |
Fax Number: | 3367586054 |
NPI Enumeration Date: | 02/12/2007 |
NPI Last Update Date: | 01/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QS1000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Student Health |
Taxonomy Definition: |