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General NPI Number Information
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NPI Number | 1205894029
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Entity Type | Organization
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Legal Business Name | FOUNDATION HEALTH SYSTEMS LLC
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 1903 S HAWTHORNE RD
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City | WINSTON SALEM
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State | NC
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Zip | 27103-3916
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Country | US
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Telephone | 336-718-6700
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Fax | 336-718-6798
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Provider Business Mailing Address
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Address Line | PO BOX 601791
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City | CHARLOTTE
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State | NC
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Zip | 28260-1791
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Country | US
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Telephone | 336-751-8003
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Fax | 336-751-8030
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Authorized Official
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Title or Position | DIRECTOR
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Name | GREGORY BIELEC
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Credential |
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Telephone | 704-316-1550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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