Provider Demographics
NPI:1104649532
Name:HERS BREAST CANCER FOUNDATION
Entity type:Organization
Organization Name:HERS BREAST CANCER FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:LALWANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-790-1911
Mailing Address - Street 1:2500 MOWRY AVE # 130
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1605
Mailing Address - Country:US
Mailing Address - Phone:510-790-1911
Mailing Address - Fax:510-505-9160
Practice Address - Street 1:164 N L ST STE 107
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-2118
Practice Address - Country:US
Practice Address - Phone:925-273-7000
Practice Address - Fax:510-505-9160
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HERS BREAST CANCER FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies