Provider Demographics
NPI:1376361204
Name:PIEDMONT HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:PIEDMONT HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:FUSE
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-933-8494
Mailing Address - Street 1:PO BOX 17179
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-7179
Mailing Address - Country:US
Mailing Address - Phone:919-933-8494
Mailing Address - Fax:919-933-9201
Practice Address - Street 1:105 CONNER DR STE 2100
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7126
Practice Address - Country:US
Practice Address - Phone:919-951-7600
Practice Address - Fax:919-933-9201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-30
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)