Provider Demographics
NPI:1093989279
Name:SOUTHERN PIEDMONT COMMUNITY CARE PLAN, INC.
Entity Type:Organization
Organization Name:SOUTHERN PIEDMONT COMMUNITY CARE PLAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:OAKES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:704-783-1516
Mailing Address - Street 1:845 CHURCH ST N
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-4300
Mailing Address - Country:US
Mailing Address - Phone:704-783-4191
Mailing Address - Fax:704-783-1459
Practice Address - Street 1:845 CHURCH ST N
Practice Address - Street 2:SUITE 103
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4300
Practice Address - Country:US
Practice Address - Phone:704-783-4191
Practice Address - Fax:704-783-1459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management