Provider Demographics
NPI:1326655036
Name:FOREIT MEDICAL, LLC
Entity Type:Organization
Organization Name:FOREIT MEDICAL, LLC
Other - Org Name:FOCUSED PAIN RELIEF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:FOREIT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:219-805-4201
Mailing Address - Street 1:2940 HIGHWAY AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-1631
Mailing Address - Country:US
Mailing Address - Phone:219-595-0630
Mailing Address - Fax:219-535-0653
Practice Address - Street 1:2940 HIGHWAY AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-1631
Practice Address - Country:US
Practice Address - Phone:219-595-0630
Practice Address - Fax:219-535-0653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-26
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty