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Organization

LIFEBRITE HOSPITAL GROUP OF STOKES, LLC

Active
Other names
LifeBrite Family Medical of King
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTIAN FLETCHER (CEO)
(336) 593-5311
Entity
Organization

Contact information

Practice address
167 MOORE RD, KING, NC 27021-8770
(336) 983-6898
(336) 983-6921
Mailing address
167 MOORE RD, KING, NC 27021-8770
(336) 983-6898
(336) 983-6921

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G557
MEDICARE PART B PTAN
NC
01
H0165
HOSPITAL LICENSURE
NC
Enumeration date
11/28/2016
Last updated
03/22/2017
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