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NPI Code Detail

MEDICARE: LOMITA GOODWIN

MEDICARE: LOMITA GOODWIN
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1372500000XChore Provider
2372600000XAdult Companion
33747A0650XAttendant Care Provider
4376J00000XHomemaker
53747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1538661095
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOMITA GOODWIN
Provider Business Mailing Address
First Line : 535 S DECATUR BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-3910
Country : US
Telephone Number : 702-562-2273
Fax Number :
Provider Business Practice Location Address
First Line : 6130 W FLAMINGO RD UNIT 202
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-2280
Country : US
Telephone Number : 702-610-3887
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2018
Last Update Date : 03/01/2018

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Directions to “ LOMITA GOODWIN ” Practice Location

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