GOODWIN STREET MEDICAL SUPPLY LLC NPI 1205802899

NPI Information

GOODWIN STREET MEDICAL SUPPLY LLC is a customized equipment durable medical equipment medical supplies in Prescott, AZ. GOODWIN STREET MEDICAL SUPPLY LLC NPI is 1205802899. The provider is registered as an organization entity type.

The provider's business location address is:

406 W GOODWIN ST
STE 1
PRESCOTT, AZ
ZIP 86303-737
Phone: (928) 541-1825
Fax: (928) 541-1823

The provider's authorized official is Michelle Irene Herod .
The authorized official title is Owner and has the following contact phone number (928) 541-1825.

The enumeration date for this NPI number is 2/24/2006 and was last updated on 5/21/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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