Healthcare Provider Details

I. General information

NPI: 1871214106
Provider Name (Legal Business Name): PIEDMONT HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2022
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7228 MONCURE PITTSBORO RD
MONCURE NC
27559-9595
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 919-542-2850
  • Fax: 919-542-9957
Mailing address:
  • Phone: 919-537-7493
  • Fax: 919-933-9201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KELLY BEST STOUT
Title or Position: CHIEF PHARMACY OFFICER
Credential: RPH
Phone: 919-537-7493