Organization
PIEDMONT INFUSION SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACOB BETHEL PATTERSON JR. RPH (OWNER)
(434) 792-6387
Entity
Organization
Contact information
Practice address
111 MALL DR, DANVILLE, VA 24540-4069
(434) 792-6387
(434) 792-6389
Mailing address
111 MALL DR, DANVILLE, VA 24540-4069
(434) 792-6387
(434) 792-6389
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
0201004278
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023253895
—
VA
05
—
1285879049
—
VA
01
—
Q415740001
MEDICARE PTAN
VA
Enumeration date
06/04/2012
Last updated
10/12/2022
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