MEDICARE: FORGHAB'S GLOBAL HEALTH CONSULTING 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	332B00000X	Durable Medical Equipment & Medical Supplies	PH25199	FL

General Provider Information

NPI Number	:	1649560509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORGHAB'S GLOBAL HEALTH CONSULTING LLC

Provider Business Mailing Address
First Line	:	4160 N. ARMENIA AVE STE C
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607
Country	:	US
Telephone Number	:	813-644-6845
Fax Number	:	813-644-6850

Provider Business Practice Location Address
First Line	:	4160 N ARMENIA AVE STE C
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6453
Country	:	US
Telephone Number	:	813-644-6850
Fax Number	:	813-644-6850

Authorized Official
Title or Position	:	OWNER/PHARMACY MANAGER
Name	:	DR. MICHAEL YIMNAI FORGHAB
Credential	:	PHARM D
Telephone Number	:	813-644-6845

Provider Enumeration Date	:	04/13/2011
Last Update Date	:	04/13/2011

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