National Provider Identifier Database

HAZEL FORMAN
Home Modifications

A contractor who makes modifications to homes to accommodate a health condition.


Contact Information

HAZEL FORMAN
1200 MOODY ST
GREENSBORO, NC27401-4217
Phone: 336-860-4060
Fax: 336-937-9157
Website:
Specialty Taxonomy Code
* Home Modifications 171WH0202X
Nursing Home Administrator 376G00000X

* Indicates primary specialty

NPI Profile & details for HAZEL FORMAN

NPI Number 1205428992
Credentials
Entity Individual
Enumeration date 02/04/2021
Last updated 05/12/2022 - About 4 years ago
Sole proprietor1 No
Identifiers
  • NC License #: FCL-041-081
  • NC License #: FCL-041-082
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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