MEDICARE: KENNETH GOFF

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	343900000X	Non-emergency Medical Transport (VAN)
2	347C00000X	Private Vehicle
3	376J00000X	Homemaker

General Provider Information

NPI Number	:	1750276663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH GOFF

Provider Business Mailing Address
First Line	:	435 MARION AVE
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44903-2052
Country	:	US
Telephone Number	:	419-571-9049
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 MARION AVE
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44903-2052
Country	:	US
Telephone Number	:	419-571-9049
Fax Number	:

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

Provider Enumeration Date	:	06/11/2025
Last Update Date	:	06/11/2025

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Directions to “ KENNETH GOFF ” Practice Location

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