| Piedmont Behavioral Services, Pc | |
|
3200 Waterfield Dr Garner NC 27529 | |
| (601) 622-5652 | |
| Not Available |
| Full Name | Piedmont Behavioral Services, Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3200 Waterfield Dr, Garner, North Carolina |
| Authorized Official Name and Position | Ijaz Rasul (PRESIDENT) |
| Authorized Official Contact | 6016225652 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Piedmont Behavioral Services, Pc 130 Preston Executive Dr Ste 102 Cary NC 27513-8433 Ph: (919) 297-2930 | Piedmont Behavioral Services, Pc 3200 Waterfield Dr Garner NC 27529 Ph: (601) 622-5652 |
| NPI Number | 1225451776 |
|---|---|
| Provider Enumeration Date | 02/03/2014 |
| Last Update Date | 06/08/2018 |
| Medicare PECOS PAC ID | 1850617176 |
|---|---|
| Medicare Enrollment ID | O20150304001706 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225451776 | NPI | - | NPPES |
| 5922235 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 2012-01584 (North Carolina) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Ijaz Rasul |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770719551 PECOS PAC ID: 7416100516 Enrollment ID: I20130122000573 |
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