MEDICARE: MR. EDDIE W. FOREN BC-H.I.S.

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	237700000X	Hearing Instrument Specialist	153	NV

General Provider Information

NPI Number	:	1164731238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EDDIE W. FOREN BC-H.I.S.

Provider Business Mailing Address
First Line	:	9480 S EASTERN AVE
Second Line	:	SUITE #228
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-8024
Country	:	US
Telephone Number	:	702-260-4655
Fax Number	:	702-260-4665

Provider Business Practice Location Address
First Line	:	9480 S EASTERN AVE
Second Line	:	SUITE #228
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-8024
Country	:	US
Telephone Number	:	702-260-4655
Fax Number	:	702-260-4665

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2010
Last Update Date	:	10/06/2010

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