Organization
GO MO, LLC
Active
Other names
Merle Norman Cosmetics
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA BRADLEY (OWNER)
(541) 957-1150
Entity
Organization
Contact information
Practice address
627 SE JACKSON ST, ROSEBURG, OR 97470
(541) 957-1150
Mailing address
627 SE JACKSON ST, ROSEBURG, OR 97470-4935
(541) 957-1150
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
601284-86
STATE REGISTRY NUMBER
OR
Enumeration date
06/21/2017
Last updated
07/21/2022
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