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Organization
FORSYTH COMMUNITY PCC LLC
Active
Organization
FORSYTH COMMUNITY PCC LLC
Active
Other names
Highland Avenue Primary Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LEEA JEANINE WALTON (RCS MANAGER)
(704) 316-6081
Entity
Organization
Contact information
Practice address
650 HIGHLAND AVE STE 120, WINSTON SALEM, NC 27101-4304
(336) 718-4770
(336) 718-4779
Mailing address
PO BOX 603582, CHARLOTTE, NC 28260-3582
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/23/2018
Last updated
07/12/2023
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