MEDICARE: TIFFANY L BENEDICT

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	1744P3200X	Prosthetics Case Management		NC

General Provider Information

NPI Number	:	1659235927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY L BENEDICT

Provider Business Mailing Address
First Line	:	1404 HYALYN CT
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27406-9557
Country	:	US
Telephone Number	:	336-858-3474
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 CENTERVIEW DR STE 100
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-3712
Country	:	US
Telephone Number	:	336-858-3474
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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Directions to “ TIFFANY L BENEDICT ” Practice Location

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