Provider Demographics
NPI:1508570227
Name:FORWARD INTERNATIONAL LLC
Entity Type:Organization
Organization Name:FORWARD INTERNATIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHANEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:DOULA
Authorized Official - Phone:415-326-4576
Mailing Address - Street 1:2124 KITTREDGE ST # 113
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1486
Mailing Address - Country:US
Mailing Address - Phone:213-646-9377
Mailing Address - Fax:
Practice Address - Street 1:4 EMBARCADERO CTR STE 1400
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-4164
Practice Address - Country:US
Practice Address - Phone:415-326-4576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare