MEDICARE: SUSAN FORBES

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	183500000X	Pharmacist	03120544	OH

General Provider Information

NPI Number	:	1972177616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN FORBES

Provider Business Mailing Address
First Line	:	38495 THORTON LN
Second Line	:
City	:	AVON
State	:	OH
Zip	:	44011-5207
Country	:	US
Telephone Number	:	440-821-8131
Fax Number	:

Provider Business Practice Location Address
First Line	:	443 CLEVELAND ST
Second Line	:
City	:	ELYRIA
State	:	OH
Zip	:	44035-4062
Country	:	US
Telephone Number	:	440-365-7162
Fax Number	:

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

Provider Enumeration Date	:	05/17/2021
Last Update Date	:	05/17/2021

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Directions to “ SUSAN FORBES ” Practice Location

Language	Start Address	Practice Location

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