Organization
GOODWILL INVALID COACH SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAGWA ELNOUR (OWNER)
(856) 661-3665
Entity
Organization
Contact information
Practice address
111 CHESTNUT ST, SUITE 605, CHERRY HILL, NJ 08002-1841
(856) 667-3565
(856) 667-3565
Mailing address
111 CHESTNUT ST, SUITE 605, CHERRY HILL, NJ 08002-1841
(856) 667-3565
(856) 667-3565
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
7528906
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7528906
—
NJ
Enumeration date
04/22/2007
Last updated
08/22/2020
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