Provider Demographics
NPI:1619678851
Name:GOLD AND FIRE LLC
Entity Type:Organization
Organization Name:GOLD AND FIRE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REPRESENTATIVE
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-422-3289
Mailing Address - Street 1:17910 VAN DYKE ST.
Mailing Address - Street 2:SUITE 1264
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48066
Mailing Address - Country:US
Mailing Address - Phone:313-564-5988
Mailing Address - Fax:
Practice Address - Street 1:17910 VAN DYKE ST # 1264
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-3954
Practice Address - Country:US
Practice Address - Phone:313-564-5988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-14
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332H00000XSuppliersEyewear Supplier
No333300000XSuppliersEmergency Response System Companies
No335E00000XSuppliersProsthetic/Orthotic Supplier
No335G00000XSuppliersMedical Foods Supplier
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier