Provider Demographics
NPI:1922102011
Name:FOSTER MEDICAL SUPPLIES & EUIP
Entity Type:Organization
Organization Name:FOSTER MEDICAL SUPPLIES & EUIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ESMILSY
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-889-5025
Mailing Address - Street 1:3867 S. VALLEY VIEW BAY
Mailing Address - Street 2:# 33
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103
Mailing Address - Country:US
Mailing Address - Phone:702-889-5025
Mailing Address - Fax:702-889-5035
Practice Address - Street 1:3867 S. VALLEY VIEW BAY
Practice Address - Street 2:# 33
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103
Practice Address - Country:US
Practice Address - Phone:702-889-5025
Practice Address - Fax:702-889-5035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2000106424332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies