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General NPI Number Information
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NPI Number | 1619935434
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Entity Type | Organization
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Legal Business Name | FOUNDATION HEALTH SYSTEMS CORP.
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 485 VALLEY RD SUITE 102
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City | MOCKSVILLE
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State | NC
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Zip | 27028-2074
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Country | US
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Telephone | 336-751-8003
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 FRONTIS PLAZA BLVD STE 200 (ATTN) FORSYTH MEDICAL GROUP
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City | WINSTON SALEM
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State | NC
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Zip | 27103-5616
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Country | US
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Telephone | 336-277-2435
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Fax | 336-277-9275
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Authorized Official
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Title or Position | EXE.VP & CCO & ADMIN
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Name | SALLY LINER
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Credential |
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Telephone | 336-277-1473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #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 | 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 #4
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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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