Healthcare Provider Details

I. General information

NPI: 1417093469
Provider Name (Legal Business Name): PIEDMONTSTONE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N LINDSAY ST
HIGH POINT NC
27262-4306
US

IV. Provider business mailing address

PO BOX 25866
WINSTON SALEM NC
27114-5866
US

V. Phone/Fax

Practice location:
  • Phone: 336-878-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QL0400X
TaxonomyLithotripsy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHARLES H HAUSER
Title or Position: CEO
Credential:
Phone: 336-714-2500