Provider Demographics
NPI:1790513018
Name:GOLDMOND HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:GOLDMOND HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHIDI
Authorized Official - Middle Name:S
Authorized Official - Last Name:JONATHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-538-9578
Mailing Address - Street 1:2 VALIANT CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-2606
Mailing Address - Country:US
Mailing Address - Phone:571-538-9578
Mailing Address - Fax:
Practice Address - Street 1:10432 BALLS FORD RD STE 314
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-2514
Practice Address - Country:US
Practice Address - Phone:571-538-9578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health