Provider Demographics
NPI:1205477999
Name:GOODMAN, AFRICA C
Entity type:Individual
Prefix:
First Name:AFRICA
Middle Name:C
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:GOODMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:716 E FAIRFIELD RD
Mailing Address - Street 2:STE 114
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605
Mailing Address - Country:US
Mailing Address - Phone:864-558-0044
Mailing Address - Fax:864-568-5150
Practice Address - Street 1:716 E FAIRFIELD RD
Practice Address - Street 2:STE 114
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605
Practice Address - Country:US
Practice Address - Phone:864-558-0044
Practice Address - Fax:864-568-5150
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care