1689673279 NPI number — PIEDMONT NEPHROLOGY & HYPERTENSION ASSOCIATES, PA

Table of content: (NPI 1689673279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689673279 NPI number — PIEDMONT NEPHROLOGY & HYPERTENSION ASSOCIATES, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PIEDMONT NEPHROLOGY & HYPERTENSION ASSOCIATES, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
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NPI Number Information

NPI Number:
1689673279
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/11/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1899 TATE BLVD SE
Provider Second Line Business Mailing Address:
SUITE 2101
Provider Business Mailing Address City Name:
HICKORY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28602-4200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-327-7788
Provider Business Mailing Address Fax Number:
828-327-0112

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1899 TATE BLVD SE
Provider Second Line Business Practice Location Address:
SUITE 2101
Provider Business Practice Location Address City Name:
HICKORY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28602-4200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-327-7788
Provider Business Practice Location Address Fax Number:
828-327-0112
Provider Enumeration Date:
07/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
WEAVER
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
828-327-7788

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  32718 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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