Provider Demographics
NPI:1578696910
Name:PIEDMONT ACCESS TO HEALTH SERVICES INC
Entity Type:Organization
Organization Name:PIEDMONT ACCESS TO HEALTH SERVICES INC
Other - Org Name:HEALTH CENTER OF PIEDMONT DANVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDENHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-791-3630
Mailing Address - Street 1:705 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-1803
Mailing Address - Country:US
Mailing Address - Phone:434-791-4122
Mailing Address - Fax:434-791-4126
Practice Address - Street 1:705 MAIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-1803
Practice Address - Country:US
Practice Address - Phone:434-791-4122
Practice Address - Fax:434-791-4126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1578696910Medicaid
VA491863Medicare Oscar/Certification