MEDICARE: REGINA GOGGANS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	376J00000X	Homemaker
2	343900000X	Non-emergency Medical Transport (VAN)
3	385H00000X	Respite Care
4	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care

General Provider Information

NPI Number	:	1174203830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGINA GOGGANS

Provider Business Mailing Address
First Line	:	24520 RANDOLPH RD
Second Line	:
City	:	BEDFORD HTS
State	:	OH
Zip	:	44146-3941
Country	:	US
Telephone Number	:	216-854-9999
Fax Number	:

Provider Business Practice Location Address
First Line	:	24520 RANDOLPH RD
Second Line	:
City	:	BEDFORD HTS
State	:	OH
Zip	:	44146-3941
Country	:	US
Telephone Number	:	216-854-9999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2023
Last Update Date	:	07/18/2023

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Directions to “ REGINA GOGGANS ” Practice Location

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