MEDICARE: FOSTER MEDICAL SUPPLIES & EUIP

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	2000106424	NV

General Provider Information

NPI Number	:	1922102011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOSTER MEDICAL SUPPLIES & EUIP

Provider Business Mailing Address
First Line	:	3867 S. VALLEY VIEW BAY
Second Line	:	# 33
City	:	LAS VEGAS
State	:	NV
Zip	:	89103
Country	:	US
Telephone Number	:	702-889-5025
Fax Number	:	702-889-5035

Provider Business Practice Location Address
First Line	:	3867 S. VALLEY VIEW BAY
Second Line	:	# 33
City	:	LAS VEGAS
State	:	NV
Zip	:	89103
Country	:	US
Telephone Number	:	702-889-5025
Fax Number	:	702-889-5035

Authorized Official
Title or Position	:	OWNER
Name	:	MS. ESMILSY FOSTER
Credential	:
Telephone Number	:	702-889-5025

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	07/21/2022

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