Healthcare Provider Details

I. General information

NPI: 1497058804
Provider Name (Legal Business Name): PIEDMONT HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2010
Last Update Date: 05/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1214 VAUGHN RD STE 101
BURLINGTON NC
27217-2863
US

IV. Provider business mailing address

299 LLOYD ST
CARRBORO NC
27510-1821
US

V. Phone/Fax

Practice location:
  • Phone: 336-532-0000
  • Fax:
Mailing address:
  • Phone: 919-933-8494
  • Fax: 919-933-9201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNC

VIII. Authorized Official

Name: MR. BRIAN TOOMEY
Title or Position: CEO
Credential:
Phone: 919-933-8494