Provider Demographics
NPI:1760550891
Name:GOLDY MEDICAL SERVICES
Entity Type:Organization
Organization Name:GOLDY MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FITZPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-261-9566
Mailing Address - Street 1:54 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-1733
Mailing Address - Country:US
Mailing Address - Phone:609-261-9566
Mailing Address - Fax:609-702-0564
Practice Address - Street 1:54 HIGH ST
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060-1733
Practice Address - Country:US
Practice Address - Phone:609-261-9566
Practice Address - Fax:609-702-0564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2475405Medicaid
NJ0318770001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER