Provider Demographics
NPI:1487393898
Name:PIEDMONT VASCULAR ACCESS SERVICES, PLLC
Entity type:Organization
Organization Name:PIEDMONT VASCULAR ACCESS SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:CHADWICK
Authorized Official - Last Name:VANDYKE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:844-434-7422
Mailing Address - Street 1:7004 KILEY CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:NC
Mailing Address - Zip Code:27298-9346
Mailing Address - Country:US
Mailing Address - Phone:336-266-9386
Mailing Address - Fax:336-464-2663
Practice Address - Street 1:7004 KILEY CT
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:27298-9346
Practice Address - Country:US
Practice Address - Phone:336-266-9386
Practice Address - Fax:336-464-2663
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PIEDMONT ACCESS MANAGEMENT GROUP, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-02
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty