# WINSTON SALEM STATE UNIVERSITY, A. H. RAY STUDENT HEALTH SERVICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376716811
- **Authorized official:** DR. MELODY C. PIERCE PHD (VICE CHANCELLOR STUDENT AFFAIRS)
- **Authorized official phone:** (336) 750-3203

## Contact information

- **Practice address:** 601 S MARTIN LUTHER KING JR DR, RM 244, A. H. RAY BUILDING, WINSTON SALEM, NC 27110-0001
- **Practice address phone:** (336) 750-3300
- **Mailing address:** 601 S MARTIN LUTHER KING JR DR, RM 244, A. H. RAY BUILDING, WINSTON SALEM, NC 27110-0001
- **Mailing address phone:** (336) 750-3300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1000X | Student Health Clinic/Center | NC AW 5031 924 | NC | Yes |

## Other

- **Enumeration date:** 04/04/2008
- **Last updated:** 06/19/2008