Provider Demographics
NPI:1093841926
Name:FORESTERS MEDICAL SUPPLY
Entity Type:Organization
Organization Name:FORESTERS MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ST FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:UZOARU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-673-9910
Mailing Address - Street 1:722 N LA BREA AVE
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-2204
Mailing Address - Country:US
Mailing Address - Phone:310-673-9910
Mailing Address - Fax:310-673-9914
Practice Address - Street 1:722 N LA BREA AVE
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-2204
Practice Address - Country:US
Practice Address - Phone:310-673-9910
Practice Address - Fax:310-673-9914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4655220002Medicare NSC