Individual ProviderVicki HardyFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1601 Owen Dr, Fayetteville, NC 28304-3425(910) 678-0100PECOS EnrollmentBased on the most recent information from CMS, provider Vicki Hardy is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1053534669Provider TypeIndividualFull NameHardy, VickiCredentialD.O.GenderFemaleSole ProprietorNoEnumeration Date4/11/2007Last Updated3/24/2022Contact InformationPractice LocationPractice Address1601 Owen Dr, Fayetteville, NC 28304-3425Phone(910) 678-0100Fax(910) 786-0115Mailing LocationMailing Address1601 Owen Dr, Fayetteville, NC 28304-3425Phone(910) 678-0100Fax(910) 678-7022Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense2008-00988North CarolinaProvider IdentifiersIDDescriptionIssuerID5910506DescriptionMedicaidIssuerUnlistedNorth Carolina