Healthcare Provider Details

I. General information

NPI: 1386906204
Provider Name (Legal Business Name): HEALTH SCIENCES FOUNDATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2012
Last Update Date: 06/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 MEMORIAL DR
JACKSONVILLE NC
28546-6328
US

IV. Provider business mailing address

2507 DELANEY AVE
WILMINGTON NC
28403-6003
US

V. Phone/Fax

Practice location:
  • Phone: 910-772-9202
  • Fax: 910-772-9452
Mailing address:
  • Phone: 910-772-9202
  • Fax: 910-007-9452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT HARDYMAN
Title or Position: DIRECTOR OF BILLING
Credential:
Phone: 910-772-9202