Provider Demographics
NPI:1417201393
Name:UNITED SOFT GOOD ASSOCIATES, LLC
Entity Type:Organization
Organization Name:UNITED SOFT GOOD ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MOSHER
Authorized Official - Suffix:
Authorized Official - Credentials:BOC
Authorized Official - Phone:231-932-8702
Mailing Address - Street 1:5123 N ROYAL DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-9201
Mailing Address - Country:US
Mailing Address - Phone:231-932-8701
Mailing Address - Fax:231-932-8762
Practice Address - Street 1:5123 N ROYAL DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-9201
Practice Address - Country:US
Practice Address - Phone:231-932-8702
Practice Address - Fax:231-932-8762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332B00000X332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies