Goodwill Medical Supply Inc

Primary specialty

Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X

License

001569 Issued in GA

Legal business name

GOODWILL MEDICAL SUPPLY INC

Practice address

903 Pavilion CT Ste J
McDonough, GA 30253-6672

Phone

(770) 957-8144

Fax

(770) 957-8140

NPI assigned

Jun 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Equere Eyo Uboh

Title

Managing Director

Phone

(770) 957-8144

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189728000000",
    "number": "1801823117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 PAVILION CT STE J",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536672",
            "telephone_number": "770-957-8144",
            "fax_number": "770-957-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 PAVILION CT STE J",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536672",
            "telephone_number": "770-957-8144",
            "fax_number": "770-957-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWILL MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-09-14",
        "status": "A",
        "authorized_official_last_name": "UBOH",
        "authorized_official_first_name": "EQUERE",
        "authorized_official_middle_name": "EYO",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "770-957-8144",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "GA",
            "license": "001569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• God'S Promise Center, Inc.
• Rachel Michele Goff
• Gofs McDonough LLC
• Debois Gooden
• Mallory Brooke Goodenow, M.S.ED. CCC-SLP
• Dara Nicole Goodwin
• Sabina Gabrielle Gordon, FNP-C
• Candice Gould, LCSW
• Sridevi Gowravaram, MD
• Grace & Peace Christian Counseling & Consulting Services, LLC

• Parenteral & Enteral Nutrition Supplies (DME) in McDonough, GA
• Providers in McDonough, GA by specialty
• Parenteral & Enteral Nutrition Supplies (DME) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; 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.