Provider Demographics
NPI:1750567467
Name:PIEDMONT HEALTHCARE, P.A.
Entity type:Organization
Organization Name:PIEDMONT HEALTHCARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGED CARE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-873-4277
Mailing Address - Street 1:PO BOX 601041
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1041
Mailing Address - Country:US
Mailing Address - Phone:704-873-4277
Mailing Address - Fax:704-978-3549
Practice Address - Street 1:633 BROOKDALE DR
Practice Address - Street 2:SUITE 300
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-3403
Practice Address - Country:US
Practice Address - Phone:704-873-3250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1126610017Medicare NSC