MEDICARE: PIEDMONT HEALTH SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1245163161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIEDMONT HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	88 VILCOM CENTER DR STE 110
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27514-1660
Country	:	US
Telephone Number	:	407-369-0189
Fax Number	:	919-933-9201

Provider Business Practice Location Address
First Line	:	1900 NEW HOPE CHURCH RD
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27514-9566
Country	:	US
Telephone Number	:	919-942-9696
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DANIELLA JAIMES-COLINA
Credential	:
Telephone Number	:	407-369-0189

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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