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Organization

PACE OF THE SOUTHERN PIEDMONT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES RICHARD GRAHAM (EXECUTIVE DIRECTOR)
(704) 887-3840
Entity
Organization

Contact information

Practice address
6133 THE PLAZA, CHARLOTTE, NC 28215
(704) 887-3840
(704) 887-3844
Mailing address
6133 THE PLAZA, CHARLOTTE, NC 28215
(704) 887-3840
(704) 887-3844

Taxonomy

Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
NC

Other

Enumeration date
09/19/2012
Last updated
09/19/2012
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