Healthcare Provider Details

I. General information

NPI: 1891445391
Provider Name (Legal Business Name): GOOLOO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2022
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7354 E BAKER DR
SCOTTSDALE AZ
85266-1891
US

IV. Provider business mailing address

7354 E BAKER DR
SCOTTSDALE AZ
85266-1891
US

V. Phone/Fax

Practice location:
  • Phone: 602-430-8647
  • Fax: 602-419-2044
Mailing address:
  • Phone: 602-430-8647
  • Fax: 602-419-2044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: ALISON MCILROY
Title or Position: PRESIDENT
Credential:
Phone: 602-430-8647