# FORSYTH MEMORIAL HOSPITAL, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FORSYTH MEMORIAL HOSPITAL, INC
- **Other names:** Salem Family Practice at Gateway
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1841469590
- **Legal business name:** FORSYTH MEMORIAL HOSPITAL, INC
- **Authorized official:** MICHELE GRIER (VP OPERATIONS)
- **Authorized official phone:** (336) 277-2421

## Contact information

- **Practice address:** 390 SALEM AVENUE, DBA SALEM FAMILY PRACTICE AT GATEWAY, WINSTON-SALEM, NC 27101
- **Practice address phone:** (336) 721-2375
- **Practice address fax:** (336) 721-2394
- **Mailing address:** 2000 FRONTIS PLAZA BLVD STE 102, WINSTON SALEM, NC 27103-5616
- **Mailing address phone:** (336) 277-2435
- **Mailing address fax:** (336) 277-9275

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/27/2008
- **Last updated:** 02/27/2008