Healthcare Provider Details
I. General information
NPI: 1821891524
Provider Name (Legal Business Name): BROOK FOREST DME LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/28/2025
Last Update Date: 03/28/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1931 G ST
FRESNO CA
93706-1618
US
IV. Provider business mailing address
3715 LAKE BEND SHORE DR
SPRING TX
77386-4555
US
V. Phone/Fax
- Phone: 559-218-5914
- Fax: 559-552-9660
- Phone: 808-356-9048
- Fax: 559-552-9660
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAUL
MESSER
Title or Position: OWNER
Credential:
Phone: 346-413-3685