MEDICARE: KAREEM LEWIS FORDHAM

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1720807225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREEM LEWIS FORDHAM

Provider Business Mailing Address
First Line	:	6729 TWO NOTCH RD STE M1225715
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-7535
Country	:	US
Telephone Number	:	803-606-2534
Fax Number	:

Provider Business Practice Location Address
First Line	:	6729 TWO NOTCH RD STE M1225715
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-7535
Country	:	US
Telephone Number	:	803-606-2534
Fax Number	:

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

Provider Enumeration Date	:	10/10/2024
Last Update Date	:	10/10/2024

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Directions to “ KAREEM LEWIS FORDHAM ” Practice Location

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