Provider Demographics
NPI:1639639495
Name:GOLD & SILVER
Entity Type:Organization
Organization Name:GOLD & SILVER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:AFOLABI
Authorized Official - Middle Name:A
Authorized Official - Last Name:OLURIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-387-7911
Mailing Address - Street 1:1437 WENTWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-6036
Mailing Address - Country:US
Mailing Address - Phone:777-387-7911
Mailing Address - Fax:
Practice Address - Street 1:1437 WENTWORTH AVE
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-6036
Practice Address - Country:US
Practice Address - Phone:777-387-7911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker