Healthcare Provider Details

I. General information

NPI: 1639739584
Provider Name (Legal Business Name): PIEDMONT HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2019
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 CONNER DR STE 100
CHAPEL HILL NC
27514-7112
US

IV. Provider business mailing address

88 VILCOM CENTER DR STE 110
CHAPEL HILL NC
27514-1660
US

V. Phone/Fax

Practice location:
  • Phone: 919-951-7600
  • Fax:
Mailing address:
  • Phone: 919-933-8494
  • Fax: 919-933-9201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DANIELLA JAIMES-COLINA
Title or Position: CEO
Credential:
Phone: 984-358-4691