MEDICARE: DAVID SCOTT FORREST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	1640IR	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2031007	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023173457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID SCOTT FORREST

Provider Business Mailing Address
First Line	:	42242 VETERANS AVE
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70403-1423
Country	:	US
Telephone Number	:	985-542-7230
Fax Number	:	985-542-7288

Provider Business Practice Location Address
First Line	:	42242 VETERANS AVE
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70403-1423
Country	:	US
Telephone Number	:	985-542-7230
Fax Number	:	985-542-7288

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID FORREST
Credential	:	RPH
Telephone Number	:	985-542-7230

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	02/20/2017

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