Organization
GOODWIN STREET MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE IRENE HEROD (OWNER)
(928) 541-1825
Entity
Organization
Contact information
Practice address
1202 WILLOW CREEK RD, PRESCOTT, AZ 86301-1428
(928) 541-1825
(928) 541-1823
Mailing address
1202 WILLOW CREEK RD, PRESCOTT, AZ 86301-1428
(928) 541-1825
(928) 541-1823
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
20002621
AZ
Other
Enumeration date
02/24/2006
Last updated
07/11/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up