Provider Demographics
NPI:1720343866
Name:FORTHRUST SERVICES, LLC
Entity Type:Organization
Organization Name:FORTHRUST SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KWESI
Authorized Official - Middle Name:E
Authorized Official - Last Name:BAIDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-375-2379
Mailing Address - Street 1:7191 SERENOA DR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-5133
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7191 SERENOA DR
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-5133
Practice Address - Country:US
Practice Address - Phone:614-309-8804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-04
Last Update Date:2012-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care