Provider Demographics
| NPI: | 1013028406 |
|---|---|
| Name: | FORUM HEALTH ENTERPRISES CO |
| Entity type: | Organization |
| Organization Name: | FORUM HEALTH ENTERPRISES CO |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | DIRECTOR |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | TIMOTHY |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | NELSON |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 330-884-4850 |
| Mailing Address - Street 1: | PO BOX 1113 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | YOUNGSTOWN |
| Mailing Address - State: | OH |
| Mailing Address - Zip Code: | 44501-1113 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 330-884-4850 |
| Mailing Address - Fax: | 330-884-0011 |
| Practice Address - Street 1: | 500 GYPSY LN |
| Practice Address - Street 2: | |
| Practice Address - City: | YOUNGSTOWN |
| Practice Address - State: | OH |
| Practice Address - Zip Code: | 44504-1315 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 330-884-4570 |
| Practice Address - Fax: | 330-884-0011 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-08-31 |
| Last Update Date: | 2025-09-11 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
| No | 207LC0200X | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | Group - Multi-Specialty |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 2080N0001X | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine | Group - Multi-Specialty |
| No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
| No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 2086S0127X | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | Group - Multi-Specialty |
| No | 208G00000X | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Group - Multi-Specialty | |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty |
