1912133489 NPI number — PIEDMONT FAMILY SERVICES

Table of content: DENISE FAY CHEN MD (NPI 1437504784)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912133489 NPI number — PIEDMONT FAMILY SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PIEDMONT FAMILY SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912133489
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/28/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1297
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHELBY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28151-1297
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-482-2460
Provider Business Mailing Address Fax Number:
704-487-5950

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 GATEWAY BLVD
Provider Second Line Business Practice Location Address:
SUITE 207
Provider Business Practice Location Address City Name:
MOORESVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28117-5596
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-664-1175
Provider Business Practice Location Address Fax Number:
704-664-1193
Provider Enumeration Date:
06/10/2009

Additional Information

Authorized Official

Authorized Official Last Name:
ECKARD
Authorized Official First Name:
JANET
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PARTNER/BUSINESS MANAGER
Authorized Official Telephone Number:
704-482-2460

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: 2005-00391 , 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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