MEDICARE: FOREST PHARMACY LLC

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	3336C0003X	Community/Retail Pharmacy

Other Identifiers

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

General Provider Information

NPI Number	:	1639848997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOREST PHARMACY LLC

Provider Business Mailing Address
First Line	:	1030 FORREST AVE STE 111
Second Line	:
City	:	DOVER
State	:	DE
Zip	:	19904-3382
Country	:	US
Telephone Number	:	302-990-3131
Fax Number	:	302-990-3135

Provider Business Practice Location Address
First Line	:	1030 FORREST AVE STE 111
Second Line	:
City	:	DOVER
State	:	DE
Zip	:	19904-3382
Country	:	US
Telephone Number	:	302-990-3131
Fax Number	:	302-990-3135

Authorized Official
Title or Position	:	OWNER
Name	:	SAFWAT IBRAHIUM
Credential	:
Telephone Number	:	646-409-6020

Provider Enumeration Date	:	09/09/2021
Last Update Date	:	05/30/2025

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Directions to “FOREST PHARMACY LLC ” Practice Location

Language	Start Address	Practice Location

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