Organization
GOOD SHEPHERD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEAVEN G MIRUTS (OWNER)
(720) 373-3609
Entity
Organization
Contact information
Practice address
2403 TYSON LAKE DR, JACKSONVILLE, FL 32221-2847
(720) 373-3609
Mailing address
2403 TYSON LAKE DR, JACKSONVILLE, FL 32221-2847
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
10/30/2024
Last updated
10/30/2024
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