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General NPI Number Information
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NPI Number | 1629138805
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Entity Type | Organization
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Legal Business Name | GOOD AIR, INC.
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 01/05/2016
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Provider Practice Location Address
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Address Line | 1104 W 1ST ST
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City | OGALLALA
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State | NE
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Zip | 69153-1900
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Country | US
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Telephone | 308-284-6842
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Fax | 308-284-4115
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Provider Business Mailing Address
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Address Line | PO BOX 207
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City | OGALLALA
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State | NE
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Zip | 69153-0207
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Country | US
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Telephone | 308-284-6842
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Fax | 308-284-4115
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Authorized Official
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Title or Position | MANAGER
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Name | DALE A. BRUEGGEMAN
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Credential |
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Telephone | 308-284-6842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 20156000094
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 001-011094656
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License Number State | NE
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