Provider Demographics
NPI:1558394031
Name:FOSTER MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:FOSTER MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-327-0196
Mailing Address - Street 1:3911 SW 47TH AVE
Mailing Address - Street 2:SUITE 911
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-2818
Mailing Address - Country:US
Mailing Address - Phone:954-327-0196
Mailing Address - Fax:954-327-0128
Practice Address - Street 1:3911 SW 47TH AVE
Practice Address - Street 2:SUITE 911
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-2818
Practice Address - Country:US
Practice Address - Phone:954-327-0196
Practice Address - Fax:954-327-0128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1421332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR8446OtherBLUE CROSS BLUE SHIELD
0969770001Medicare NSC