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Organization

FHPG, LLC

Active
Other names
Montgomery County School Based Health Center-East
Organization subpart
No

Provider details

NPI number
Authorized official
MICKEY FOSTER (CEO)
(910) 715-4473
Entity
Organization

Contact information

Practice address
1122 US HIGHWAY 220 ALT S, BISCOE, NC 27209-9564
(910) 428-9392
(910) 428-1861
Mailing address
1122 US HIGHWAY 220 ALT S, BISCOE, NC 27209-9564
(910) 428-9392
(910) 428-1861

Taxonomy

Speciality
Code
Description
License number
State
363LS0200X
School Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011MJ
BCBS
NC
05
8701706
NC
01
TIN # -- SUFFIX 039
CHAMPUS TRICARE
NC
Enumeration date
10/05/2006
Last updated
08/03/2020
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