Provider Demographics
NPI:1750390654
Name:PIEDMONT HOME CARE
Entity type:Organization
Organization Name:PIEDMONT HOME CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TRESURER
Authorized Official - Prefix:
Authorized Official - First Name:M
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:HEISEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-536-5260
Mailing Address - Street 1:PO BOX 1910
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22604-8060
Mailing Address - Country:US
Mailing Address - Phone:540-536-5229
Mailing Address - Fax:540-536-2396
Practice Address - Street 1:129 WEST LEE HIGHWAY
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186
Practice Address - Country:US
Practice Address - Phone:540-349-1279
Practice Address - Fax:540-349-1286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA01319498Medicaid
5742610001Medicare NSC