Provider Demographics
NPI:1285331199
Name:GOINS, GLORIOUS
Entity type:Individual
Prefix:
First Name:GLORIOUS
Middle Name:
Last Name:GOINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 HANEY RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45416-2034
Mailing Address - Country:US
Mailing Address - Phone:323-541-6672
Mailing Address - Fax:
Practice Address - Street 1:3940 HANEY RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45416-2034
Practice Address - Country:US
Practice Address - Phone:323-541-6672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide