Provider Demographics
NPI:1295159705
Name:PIEDMONT COMPREHENSIVE PAIN MANAGEMENT GROUP LLC
Entity type:Organization
Organization Name:PIEDMONT COMPREHENSIVE PAIN MANAGEMENT GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:P
Authorized Official - Last Name:LOUDERMILK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-269-4416
Mailing Address - Street 1:100 HEALTHY WAY
Mailing Address - Street 2:SUITE 1260
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-7915
Mailing Address - Country:US
Mailing Address - Phone:864-225-3551
Mailing Address - Fax:864-328-0328
Practice Address - Street 1:3 SAINT FRANCIS DR
Practice Address - Street 2:SUITE 480
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3971
Practice Address - Country:US
Practice Address - Phone:864-269-4416
Practice Address - Fax:864-269-8989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty