MEDICARE: FOUNDATION HEALTH SYSTEMS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist
4	332B00000X	Durable Medical Equipment & Medical Supplies
5	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1700748118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUNDATION HEALTH SYSTEMS LLC

Provider Business Mailing Address
First Line	:	PO BOX 601791
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-1791
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	773 STOCKBRIDGE DR
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-7200
Country	:	US
Telephone Number	:	336-277-8757
Fax Number	:

Authorized Official
Title or Position	:	MGR. REGIONAL REHAB SERVICES
Name	:	ERIN ELIZABETH BALL
Credential	:
Telephone Number	:	336-277-8757

Provider Enumeration Date	:	11/25/2025
Last Update Date	:	11/25/2025

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Directions to “FOUNDATION HEALTH SYSTEMS LLC ” Practice Location

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