Healthcare Provider Details

I. General information

NPI: 1043141567
Provider Name (Legal Business Name): GOODBRIDGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 CANDELA CT
YORK SC
29745-2963
US

IV. Provider business mailing address

614 CANDELA CT
YORK SC
29745-2963
US

V. Phone/Fax

Practice location:
  • Phone: 240-543-1364
  • Fax:
Mailing address:
  • Phone: 240-543-1364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. GILLES MUNEZERO
Title or Position: FOUNDER
Credential:
Phone: 240-543-1364