Provider Demographics
NPI:1184482069
Name:GOMEDPRO LLC
Entity type:Organization
Organization Name:GOMEDPRO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:CREO
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-617-9508
Mailing Address - Street 1:7458 CLEAR LAKE ALY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95829-8741
Mailing Address - Country:US
Mailing Address - Phone:209-617-9508
Mailing Address - Fax:
Practice Address - Street 1:7458 CLEAR LAKE ALY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95829-8741
Practice Address - Country:US
Practice Address - Phone:209-617-9508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)