Provider Demographics
NPI:1417383431
Name:GOODWILL INDUSTRIES OF SOUTHERN NEW JERSEY AND PHILADELPHIA
Entity Type:Organization
Organization Name:GOODWILL INDUSTRIES OF SOUTHERN NEW JERSEY AND PHILADELPHIA
Other - Org Name:GOODWILL HOME MEDICAL EQUIPMENT (A SUBSIDIARY OF)
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:B
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-439-0200
Mailing Address - Street 1:832 SUNFLOWER CIR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-2102
Mailing Address - Country:US
Mailing Address - Phone:954-384-7937
Mailing Address - Fax:
Practice Address - Street 1:300 BENIGNO BLVD
Practice Address - Street 2:
Practice Address - City:BELLMAWR
Practice Address - State:NJ
Practice Address - Zip Code:08031-2512
Practice Address - Country:US
Practice Address - Phone:609-396-1513
Practice Address - Fax:609-396-1516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-23
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies