Provider Demographics
NPI:1376141085
Name:GOLDSMITH'S HEALTHCARE LLC
Entity Type:Organization
Organization Name:GOLDSMITH'S HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEDISHA
Authorized Official - Middle Name:MAURAINE
Authorized Official - Last Name:GOLDSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:175-424-2155
Mailing Address - Street 1:6088 DAVON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-3178
Mailing Address - Country:US
Mailing Address - Phone:754-242-1551
Mailing Address - Fax:
Practice Address - Street 1:6088 DAVON ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-3178
Practice Address - Country:US
Practice Address - Phone:754-242-1551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health