Provider Demographics
NPI:1700680667
Name:GOSHEN MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:GOSHEN MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:ARREY
Authorized Official - Last Name:MBU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-349-4351
Mailing Address - Street 1:4133 VILLAGE PRESERVE WAY
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30507-3321
Mailing Address - Country:US
Mailing Address - Phone:470-349-4351
Mailing Address - Fax:
Practice Address - Street 1:4133 VILLAGE PRESERVE WAY
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30507-3321
Practice Address - Country:US
Practice Address - Phone:470-349-4351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)