Healthcare Provider Details

I. General information

NPI: 1154425890
Provider Name (Legal Business Name): PIEDMONT HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 09/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 MAIN ST
PROSPECT HILL NC
27314-9438
US

IV. Provider business mailing address

PO BOX 17179
CHAPEL HILL NC
27516-7179
US

V. Phone/Fax

Practice location:
  • Phone: 336-562-3311
  • Fax: 336-562-4444
Mailing address:
  • Phone: 919-933-8494
  • Fax: 919-933-9201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MR. BRIAN TOOMEY
Title or Position: CEO
Credential:
Phone: 919-933-8494