Provider Demographics
NPI:1952830432
Name:FHPG, LLC
Entity Type:Organization
Organization Name:FHPG, LLC
Other - Org Name:FIRSTHEALTH OCCUPATIONAL HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICKEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-715-4473
Mailing Address - Street 1:522 ALLEN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NC
Mailing Address - Zip Code:27371-2861
Mailing Address - Country:US
Mailing Address - Phone:910-571-5170
Mailing Address - Fax:910-571-5175
Practice Address - Street 1:522 ALLEN ST STE 203
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NC
Practice Address - Zip Code:27371-2861
Practice Address - Country:US
Practice Address - Phone:910-571-5170
Practice Address - Fax:910-571-5175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-08
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC=========OtherTRICARE