Organization
PIEDMONT SENIOR CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMELITA SAMERA RODRIGUEZ (HR/BM)
(336) 544-5400
Entity
Organization
Contact information
Practice address
1309 N ELM STREET, GREENSBORO, NC 27401
(336) 544-5400
(336) 544-5401
Mailing address
1309 N ELM STREET, GREENSBORO, NC 27401
(336) 544-5400
(336) 544-5401
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013NH
BLUE CROSS BLUE SHIELD
NC
05
—
89013NH
—
NC
Enumeration date
11/22/2005
Last updated
11/19/2009
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