Healthcare Provider Details

I. General information

NPI: 1396067567
Provider Name (Legal Business Name): PIEDMONT PHARMACY SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2010
Last Update Date: 05/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1816 E ARBORS DR STE 410
CHARLOTTE NC
28262-2666
US

IV. Provider business mailing address

PO BOX 78317
CHARLOTTE NC
28271-7030
US

V. Phone/Fax

Practice location:
  • Phone: 704-971-9880
  • Fax: 704-971-9881
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number10488
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SONY OBUSEH
Title or Position: PHARMACY MGR/OWNER
Credential: B.PHARM
Phone: 704-243-1202