1982319745 NPI number — PIEDMONT ACCESS TO HEALTH SERVICES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982319745 NPI number — PIEDMONT ACCESS TO HEALTH SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PIEDMONT ACCESS TO HEALTH SERVICES INC
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:
6
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:
1982319745
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
116 S RIDGE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DANVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24541-1314
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-575-0153
Provider Business Mailing Address Fax Number:
833-967-4386

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
336 OLD RIVERSIDE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24541-3454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-791-4795
Provider Business Practice Location Address Fax Number:
434-791-4796
Provider Enumeration Date:
01/17/2023

Additional Information

Authorized Official

Authorized Official Last Name:
PRATT
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
ANTHONY
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
434-791-3630

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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