Provider Demographics
NPI:1558562801
Name:JOEY GOFFNEY
Entity Type:Organization
Organization Name:JOEY GOFFNEY
Other - Org Name:SOUTHERN CARE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOEY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GOFFNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-452-7046
Mailing Address - Street 1:322 CAGE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77020-6114
Mailing Address - Country:US
Mailing Address - Phone:832-452-7046
Mailing Address - Fax:
Practice Address - Street 1:322 CAGE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77020-6114
Practice Address - Country:US
Practice Address - Phone:832-452-7046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000011341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB637Medicare PIN