Provider Demographics
NPI:1548290265
Name:FHPG, LLC
Entity type:Organization
Organization Name:FHPG, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICKEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-715-4473
Mailing Address - Street 1:1035 7 LAKES DR STE C
Mailing Address - Street 2:
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376-9081
Mailing Address - Country:US
Mailing Address - Phone:910-673-0045
Mailing Address - Fax:910-673-5705
Practice Address - Street 1:1035 7 LAKES DR STE C
Practice Address - Street 2:
Practice Address - City:WEST END
Practice Address - State:NC
Practice Address - Zip Code:27376-9081
Practice Address - Country:US
Practice Address - Phone:910-673-0045
Practice Address - Fax:910-673-5705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103285207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1548290265Medicaid
NC790242LMedicaid
NC0242LOtherBCBS
NC02AY4OtherBCBS #
NC790242LMedicaid
NC02AY4OtherBCBS #