MEDICARE: FOREWARD LOGISTICS L.L.C.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	343900000X	Non-emergency Medical Transport (VAN)
3	347C00000X	Private Vehicle
4	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1487214144
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOREWARD LOGISTICS L.L.C.

Provider Business Mailing Address
First Line	:	25900 GREENFIELD RD STE 326
Second Line	:
City	:	OAK PARK
State	:	MI
Zip	:	48237-1297
Country	:	US
Telephone Number	:	877-488-9724
Fax Number	:

Provider Business Practice Location Address
First Line	:	25900 GREENFIELD RD STE 326
Second Line	:
City	:	OAK PARK
State	:	MI
Zip	:	48237-1297
Country	:	US
Telephone Number	:	877-488-9724
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. TRESA D FORE
Credential	:
Telephone Number	:	877-488-9724

Provider Enumeration Date	:	06/15/2019
Last Update Date	:	06/15/2019

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