Provider Demographics
NPI:1629138805
Name:GOOD AIR, INC.
Entity Type:Organization
Organization Name:GOOD AIR, INC.
Other - Org Name:GOOD AIR HOME MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRUEGGEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-284-6842
Mailing Address - Street 1:PO BOX 207
Mailing Address - Street 2:
Mailing Address - City:OGALLALA
Mailing Address - State:NE
Mailing Address - Zip Code:69153-0207
Mailing Address - Country:US
Mailing Address - Phone:308-284-6842
Mailing Address - Fax:308-284-4115
Practice Address - Street 1:1104 W 1ST ST
Practice Address - Street 2:
Practice Address - City:OGALLALA
Practice Address - State:NE
Practice Address - Zip Code:69153-1900
Practice Address - Country:US
Practice Address - Phone:308-284-6842
Practice Address - Fax:308-284-4115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
NE001-011094656332B00000X
CO20156000094332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0153120001Medicare NSC
0153120001Medicare ID - Type Unspecified