Healthcare Provider Details

I. General information

NPI: 1023136132
Provider Name (Legal Business Name): PIEDMONT HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 12/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7228 PITTSBORO MONCURE ROAD
MONCURE NC
27559
US

IV. Provider business mailing address

7228 PITTSBORO MONCURE ROAD
MONCURE NC
27559
US

V. Phone/Fax

Practice location:
  • Phone: 919-542-4991
  • Fax: 919-542-9957
Mailing address:
  • Phone: 919-542-4991
  • Fax: 919-542-9957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number02996
License Number StateNC

VIII. Authorized Official

Name: LYDIA F. MASON
Title or Position: CFO
Credential:
Phone: 919-933-8494