Basic Information
| Provider Information | |||||||||
| NPI: | 1982185377 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FHPG, LLC | ||||||||
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| OtherOrganizationName: | FIRSTHEALTH CARDIO PULMONARY REHAB | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2925 BEECHTREE DR | ||||||||
| Address2: | SUITE 142 | ||||||||
| City: | SANFORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9107151000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2925 BEECHTREE DR | ||||||||
| Address2: | SUITE 142 | ||||||||
| City: | SANFORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9107151000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2018 | ||||||||
| LastUpdateDate: | 03/11/2021 | ||||||||
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| AuthorizedOfficialLastName: | FOSTER | ||||||||
| AuthorizedOfficialFirstName: | MICKEY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 9107151913 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.