Organization
LIFEBRITE HOSPITAL GROUP OF STOKES, LLC
Active
Other names
LifeBrite Family Medical & Urgent Care of Pine Hall
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA PRIDDY TILLMAN (ADMINISTRATOR)
(336) 593-5314
Entity
Organization
Contact information
Practice address
3853 US 311 HWY N, PINE HALL, NC 27042-8184
(336) 593-5311
(336) 593-5350
Mailing address
3853 US 311 HWY N, PINE HALL, NC 27042-8184
(336) 427-3076
(336) 427-3256
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
H0165
NC
261QU0200X
Urgent Care Clinic/Center
H0165
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H0165
STATE LICENSURE
NC
Enumeration date
04/28/2017
Last updated
03/27/2019
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