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CH04089C PIEDMONT HEALTH SERVICES, INC. (Active)
Main Details
Name
PIEDMONT HEALTH SERVICES, INC.
Subdivision Name
CARRBORO COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004319
340B ID
CH04089C
Grant Number
H80CS00086
Contacts
Authorizing Official
Piedmont Health Services
Daniella Jaimes-Colina, Chief Executive Officer
(984) 358-4691
Primary Contact
Piedmont Health Services
Kelly B Stout, Chief Pharmacy Officer
(919) 537-7493
Additional Details
Current Program Status
Active
Registration Date
10/1/1995
Participating Start Date
10/1/1995
Participating Approval Date
8/8/2005
Last Recertification Date
2/21/2024
Addresses
Street Address
301 Lloyd St
Carrboro, NC 27510-1823
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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1/5/07 UPDATED MEDICAID # (WAS 344503B)
01/11/2010
May 2024
May 2024
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