Provider Demographics
NPI:1639848997
Name:FOREST PHARMACY LLC
Entity Type:Organization
Organization Name:FOREST PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAFWAT
Authorized Official - Middle Name:
Authorized Official - Last Name:IBRAHIUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-409-6020
Mailing Address - Street 1:1030 FORREST AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3382
Mailing Address - Country:US
Mailing Address - Phone:302-990-3131
Mailing Address - Fax:302-990-3135
Practice Address - Street 1:1030 FORREST AVE STE 111
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3382
Practice Address - Country:US
Practice Address - Phone:302-990-3131
Practice Address - Fax:302-990-3135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-09
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy