# FOREVER ACTIVE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457654253
- **Authorized official:** MS. JASMINE LIBARIAN (PRESIDENT)
- **Authorized official phone:** (626) 389-8790

## Contact information

- **Practice address:** 1421 RAILROAD ST, GLENDALE, CA 91204-2715
- **Practice address phone:** (626) 389-8790
- **Practice address fax:** (626) 466-3020
- **Mailing address:** 1421 RAILROAD ST, GLENDALE, CA 91204-2715
- **Mailing address phone:** (626) 389-8790
- **Mailing address fax:** (626) 466-3020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 12/16/2010
- **Last updated:** 12/21/2024