MEDICARE: PIEDMONT HEALTH SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871697599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIEDMONT HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 17179
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-7179
Country	:	US
Telephone Number	:	919-933-8494
Fax Number	:	919-933-9201

Provider Business Practice Location Address
First Line	:	7228 MONCURE-PITTSBORO ROAD
Second Line	:
City	:	MONCURE
State	:	NC
Zip	:	27559-0980
Country	:	US
Telephone Number	:	919-542-4991
Fax Number	:	919-542-3726

Authorized Official
Title or Position	:	CFO
Name	:	LYDIA F MASON
Credential	:
Telephone Number	:	919-933-8494

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	06/12/2019

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Directions to “PIEDMONT HEALTH SERVICES, INC ” Practice Location

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