Organization
GOOD CUSTODIAN SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PHILOMENA DESMOND (MANAGER)
(703) 580-1077
Entity
Organization
Contact information
Practice address
15426 BEVANWOOD DR, WOODBRIDGE, VA 22193-5716
(703) 580-1077
Mailing address
15426 BEVANWOOD DR, WOODBRIDGE, VA 22193-5716
(703) 580-1077
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
IM675
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IM675
MOTOR CARRIER TRANSPORTATION NUMBER
VA
Enumeration date
05/18/2018
Last updated
05/18/2018
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