Provider Demographics
NPI:1245355841
Name:MICHAEL L. GOFF, II DBA MEDICAL SERVICES
Entity type:Organization
Organization Name:MICHAEL L. GOFF, II DBA MEDICAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GOFF
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:615-771-6666
Mailing Address - Street 1:PO BOX 210075
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-0075
Mailing Address - Country:US
Mailing Address - Phone:615-384-1328
Mailing Address - Fax:615-771-0382
Practice Address - Street 1:203 5TH AVE E
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-2420
Practice Address - Country:US
Practice Address - Phone:615-384-1328
Practice Address - Fax:615-771-0382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTNPL548734332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3561186Medicaid
4366270001Medicare ID - Type Unspecified