Provider Demographics
NPI:1598364424
Name:GOOD HEALTH MEDICAL TRANSPORT, LLC.
Entity Type:Organization
Organization Name:GOOD HEALTH MEDICAL TRANSPORT, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-598-1141
Mailing Address - Street 1:13521 BIG SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONTAGUE
Mailing Address - State:CA
Mailing Address - Zip Code:96064-9684
Mailing Address - Country:US
Mailing Address - Phone:530-598-1141
Mailing Address - Fax:844-272-7701
Practice Address - Street 1:1009 HIGHWAY A12
Practice Address - Street 2:
Practice Address - City:MONTAGUE
Practice Address - State:CA
Practice Address - Zip Code:96064-9037
Practice Address - Country:US
Practice Address - Phone:530-598-1141
Practice Address - Fax:844-272-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)