Healthcare Provider Details

I. General information

NPI: 1013226612
Provider Name (Legal Business Name): GOLD MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2010
Last Update Date: 10/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1799 W 5TH AVE SUITE 252
COLUMBUS OH
43212-2322
US

IV. Provider business mailing address

1799 W 5TH AVE SUITE 252
COLUMBUS OH
43212-2322
US

V. Phone/Fax

Practice location:
  • Phone: 800-237-0836
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberN/A
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberN/A
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. SARAH HOPE BONZA
Title or Position: OWNER/ PHYSICIAN
Credential: M.D.
Phone: 800-237-0836