Organization
PIEDMONT DIALYSIS CENTER OF WAKE FOREST UNIVERSITY
Active
Other names
Piedmont Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY AGEE-CLARK JOHNSON MBA (CREDENTIALING COORD.)
(229) 387-3528
Entity
Organization
Contact information
Practice address
655 COTTON ST, WINSTON SALEM, NC 27101-5064
(336) 721-1360
(336) 773-0716
Mailing address
PO BOX 7350, TIFTON, GA 31793-7350
(229) 387-3528
(229) 386-2149
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00589
BCBS-NC
NC
05
—
3402505
—
NC
Enumeration date
12/30/2005
Last updated
02/09/2026
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