Good Custodian Services, LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

IM675 Issued in VA

Legal business name

GOOD CUSTODIAN SERVICES, LLC

Practice address

15426 Bevanwood Dr
Woodbridge, VA 22193-5716

Phone

(703) 580-1077

NPI assigned

May 18, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Philomena Desmond

Title

Manager

Phone

(703) 580-1077

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Good Custodian Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Good Custodian Services, LLC

  • Non-emergency Medical Transport (VAN)
  • Woodbridge, VA
  • NPI 1336888239
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Good Custodian Services, LLC

  • Non-emergency Medical Transport (VAN)
  • Woodbridge, VA
  • NPI 1336888239
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526601600000",
    "number": "1215428859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15426 BEVANWOOD DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221935716",
            "telephone_number": "703-580-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15426 BEVANWOOD DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221935716",
            "telephone_number": "703-580-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD CUSTODIAN SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-18",
        "last_updated": "2018-05-18",
        "status": "A",
        "authorized_official_last_name": "DESMOND",
        "authorized_official_first_name": "PHILOMENA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "703-580-1077",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "VA",
            "license": "IM675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOTOR CARRIER TRANSPORTATION NUMBER",
            "identifier": "IM675",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reza Golesorkhi, MD
• Gabriella A Gomez, WHNP
• Tony Melville Gonsalves, D.O.
• Emily Gonzalez, MS, CCC-SLP
• Tammy Gonzalez
• Good Custodian Services, LLC
• Good Grounds Health Co
• Good Shepherd Transportation LLC
• Donna Marie Goodin, CFNP
• Alyssa Goodwin

• All providers in Woodbridge, VA
• Non-emergency Medical Transport (VAN) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.