Organization
FOUNDATION HEALTH SYSTEMS, CORP
Active
Other names
The Breast Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
FRED M. HARGETT (EVP/CFO)
(704) 384-5184
Entity
Organization
Contact information
Practice address
2025 FRONTIS PLAZA BLVD, STE 300, WINSTON-SALEM, NC 27103-5663
(336) 718-4700
Mailing address
2085 FRONTIS PLAZA BLVD, WINSTON-SALEM, NC 27103-5614
(336) 277-7226
(336) 277-9795
Taxonomy
Speciality
Code
Description
License number
State
261QR0206X
Mammography Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890183E
—
NC
Enumeration date
05/12/2006
Last updated
10/26/2010
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