Provider Demographics
NPI:1396311320
Name:PIEDMONT HEALTHCARE, INC.
Entity type:Organization
Organization Name:PIEDMONT HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RPH/ PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:BETHEL
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:434-792-5227
Mailing Address - Street 1:121 MALL DRIVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540
Mailing Address - Country:US
Mailing Address - Phone:434-792-5227
Mailing Address - Fax:434-791-4615
Practice Address - Street 1:121 MALL DRIVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540
Practice Address - Country:US
Practice Address - Phone:434-792-5227
Practice Address - Fax:434-791-4615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center