Provider Demographics
NPI:1013226612
Name:GOLD MEDICAL
Entity Type:Organization
Organization Name:GOLD MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:HOPE
Authorized Official - Last Name:BONZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-237-0836
Mailing Address - Street 1:1799 W 5TH AVE
Mailing Address - Street 2:SUITE 252
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2322
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1799 W 5TH AVE
Practice Address - Street 2:SUITE 252
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2322
Practice Address - Country:US
Practice Address - Phone:800-237-0836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251G00000X, 3336H0001X
OHN/A332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1487694709OtherNPI/ INDIVIDUAL