Provider Demographics
NPI:1710021803
Name:PIEDMONT GERIATRIC HOSPITAL
Entity Type:Organization
Organization Name:PIEDMONT GERIATRIC HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY TECHNICIAN
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:DESHAWNA
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT
Authorized Official - Phone:434-767-4922
Mailing Address - Street 1:PO BOX 427
Mailing Address - Street 2:
Mailing Address - City:BURKEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23922-0427
Mailing Address - Country:US
Mailing Address - Phone:434-767-4922
Mailing Address - Fax:434-767-4935
Practice Address - Street 1:5001 EAST PATRICK HENRY HIGHWAY
Practice Address - Street 2:
Practice Address - City:BURKEVILLE
Practice Address - State:VA
Practice Address - Zip Code:23922-0427
Practice Address - Country:US
Practice Address - Phone:434-767-4922
Practice Address - Fax:434-767-4935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital