Healthcare Provider Details

I. General information

NPI: 1285879049
Provider Name (Legal Business Name): PIEDMONT INFUSION SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2008
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MALL DR
DANVILLE VA
24540-4069
US

IV. Provider business mailing address

111 MALL DR
DANVILLE VA
24540-4069
US

V. Phone/Fax

Practice location:
  • Phone: 434-792-6387
  • Fax: 434-792-6389
Mailing address:
  • Phone: 434-792-6387
  • Fax: 434-792-6389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number5734
License Number StateVA

VIII. Authorized Official

Name: MR. JACOB BETHEL PATTERSON JR.
Title or Position: OWNER
Credential: RPH
Phone: 434-792-6387