Provider Demographics
NPI:1457158537
Name:FORGE PROSTHETICS, LLC
Entity type:Organization
Organization Name:FORGE PROSTHETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:LABRASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-238-4509
Mailing Address - Street 1:7395 WHITESPIRE RD APT 12
Mailing Address - Street 2:
Mailing Address - City:SCHOFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54476-4954
Mailing Address - Country:US
Mailing Address - Phone:831-238-4509
Mailing Address - Fax:
Practice Address - Street 1:1700 STEWART AVE STE 300
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-5345
Practice Address - Country:US
Practice Address - Phone:831-238-4509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier