Healthcare Provider Details

I. General information

NPI: 1497163323
Provider Name (Legal Business Name): GOULD'S DISCOUNT MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 08/24/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2408 RING RD SUITE 600
ELIZABETHTOWN KY
42701-7938
US

IV. Provider business mailing address

220 W GERMANTOWN PIKE STE 250
PLYMOUTH MEETING PA
19462-1437
US

V. Phone/Fax

Practice location:
  • Phone: 270-506-0033
  • Fax: 270-209-0890
Mailing address:
  • Phone: 541-326-0009
  • Fax: 502-495-2476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number170285
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberMG0874
License Number StateKY

VIII. Authorized Official

Name: MR. STEPHEN GRIGGS
Title or Position: CEO
Credential:
Phone: 407-206-0040