Provider Demographics
NPI:1235679457
Name:FOOTHILL MEDICAL
Entity Type:Organization
Organization Name:FOOTHILL MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SELF EMPLOYED/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-408-6027
Mailing Address - Street 1:1065 DOROTHYS LN
Mailing Address - Street 2:
Mailing Address - City:GERMANTON
Mailing Address - State:NC
Mailing Address - Zip Code:27019-8227
Mailing Address - Country:US
Mailing Address - Phone:336-408-6027
Mailing Address - Fax:
Practice Address - Street 1:1065 DOROTHYS LN
Practice Address - Street 2:
Practice Address - City:GERMANTON
Practice Address - State:NC
Practice Address - Zip Code:27019-8227
Practice Address - Country:US
Practice Address - Phone:336-408-6027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies