Provider Demographics
NPI:1023314366
Name:GO BIG, INC.
Entity type:Organization
Organization Name:GO BIG, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:WHITTAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-252-4240
Mailing Address - Street 1:15875 SE 114TH AVE STE J
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-9025
Mailing Address - Country:US
Mailing Address - Phone:503-252-4240
Mailing Address - Fax:503-252-4246
Practice Address - Street 1:15875 SE 114TH AVE STE J
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9025
Practice Address - Country:US
Practice Address - Phone:503-252-4240
Practice Address - Fax:503-252-4246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-03
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies