Provider Demographics
NPI:1932130390
Name:FHPG, LLC
Entity Type:Organization
Organization Name:FHPG, LLC
Other - Org Name:FIRSTHEALTH FAMILY MEDICINE-CAROLINA FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR PRACTICE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-715-5181
Mailing Address - Street 1:PO BOX 17990
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4074
Mailing Address - Country:US
Mailing Address - Phone:910-895-1989
Mailing Address - Fax:910-895-9666
Practice Address - Street 1:104 PHYSICIANS PARK DRIVE
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-5204
Practice Address - Country:US
Practice Address - Phone:910-895-1989
Practice Address - Fax:910-895-9666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
NC20910207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1932130390Medicaid
NC02AYOOtherBCBSNC
NC1932130390Medicaid