=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811150972
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FORA CARE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2008
-----------------------------------------------------
Last Update Date | 03/29/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 893 PATRIOT DR STE D
-----------------------------------------------------
City | MOORPARK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93021-3357
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-498-8188
-----------------------------------------------------
Fax | 805-498-7188
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 893 PATRIOT DR STE D
-----------------------------------------------------
City | MOORPARK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93021-3357
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-498-8188
-----------------------------------------------------
Fax | 805-498-7188
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | SHU-MEI WU
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 805-498-8188
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 08-00015600
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------