Old Vineyard Physician Group

LBN: Keystone Wsnc Llc
Old Vineyard Physician Group is an health care organization with primary practice located at 3637 Old Vineyard Rd , Winston Salem NC 27104. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as the primary health care specialty. Keystone Wsnc Llc can be contacted via phone (336) 794-3550, or through Filton, Steve via phone (610) 768-3300.

Contact Information

Primary practice address
3637 Old Vineyard Rd Winston Salem NC 27104
Phone: (336) 794-3550
Fax: (336) 794-4339
Website:
Map and Directions
Authorized official contact:
Name: Filton, Steve
Phone: (610) 768-3300

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MHH0188 North Carolina

Profile Details

NPI number 1780817452
LBN Legal business name Keystone Wsnc Llc
DBA Doing business as Old Vineyard Physician Group
Authorized official Filton, Steve
Entity Organization
Organization subpart 1 No
Enumeration date Aug 28th, 2009
Last updated Sep 4th, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780817452 NPPES
North Carolina MEDICAID 5912567

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