OrganizationWake Forest Health Network Llc(<Unavail>)Internal MedicineAllopathic & Osteopathic PhysiciansPractice Address770 Highland Oaks Dr, Winston Salem, NC 27103-7105(336) 765-5250(336) 716-1331PECOS EnrollmentBased on the most recent information from CMS, provider Wake Forest Health Network Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1740249465Provider TypeOrganizationFull NameWake Forest Health Network LlcOther Name<Unavail>SubpartNoEnumeration Date3/21/2006Last Updated11/3/2023Contact InformationPractice LocationPractice Address770 Highland Oaks Dr, Winston Salem, NC 27103-7105Phone(336) 765-5250Fax(336) 659-0953Mailing LocationMailing Address100 Kimel Forest Dr, Winston Salem, NC 27103-6074Phone(336) 716-1331Fax(336) 716-3202Authorized OfficialNameHowerton, Russell Mars (Sr Vp Network Phys & Hs Cmo)Phone(336) 716-1331Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerIDCC4243DescriptionOtherIssuerRR MEDICARENorth CarolinaID5905780DescriptionMedicaidIssuerUnlistedNorth CarolinaIDCB8658DescriptionOtherIssuerRR MEDICARENorth CarolinaIDCD6614DescriptionOtherIssuerRR MEDICARENorth CarolinaIDCC4241DescriptionOtherIssuerRR MEDICARENorth Carolina