Organization
FHPG, LLC
Active
Other names
Montgomery County School Based Health Center-West
Organization subpart
No
Provider details
NPI number
Authorized official
MICKEY FOSTER (CEO)
(910) 715-4473
Entity
Organization
Contact information
Practice address
129 NCHIGHWAY 109 S, MOUNT GILEAD, NC 27306-8941
(910) 572-1979
(910) 572-1961
Mailing address
129 NC HIGHWAY 109 S, MOUNT GILEAD, NC 27306-8941
(910) 572-1979
(910) 572-1961
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
—
8701704
—
NC
01
—
TIN # -- SUFFIX 036
CHAMPUS TRICARE
NC
Enumeration date
10/05/2006
Last updated
08/03/2020
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