Provider Demographics
NPI:1578968806
Name:PIEDMONT DRUG & HOME DELIVERY, LLC
Entity Type:Organization
Organization Name:PIEDMONT DRUG & HOME DELIVERY, LLC
Other - Org Name:PIEDMONT DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:336-674-5518
Mailing Address - Street 1:4620 WOODY MILL RD
Mailing Address - Street 2:STE B
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-8779
Mailing Address - Country:US
Mailing Address - Phone:336-674-5518
Mailing Address - Fax:336-674-5590
Practice Address - Street 1:4620 WOODY MILL RD
Practice Address - Street 2:STE B
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-8779
Practice Address - Country:US
Practice Address - Phone:336-674-5518
Practice Address - Fax:336-674-5590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10387183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty