Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Goodwin Street Medical Supply LLC

Organization Customized Equipment (DME) · NPI 1205802899

Goodwin Street Medical Supply LLC provides Customized Equipment (DME) in Prescott, Arizona. Licensed in Arizona. Registered with an NPI since 2006.

Licensed in
AZ
In the registry since
2006
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1202 Willow Creek Rd
Prescott, AZ 86301-1428
Phone: (928) 541-1825
Fax: (928) 541-1823
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Customized Equipment (DME) (primary) Taxonomy 332BC3200X · Licence 20002621 (AZ)

Record details

NPI number1205802899
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michelle Herod — Owner · (928) 541-1825
NPI enumeratedFebruary 24, 2006
Last updated in NPPESJuly 11, 2026
Certification dateJuly 11, 2026
Mailing address1202 Willow Creek Rd, Prescott, AZ 86301-1428

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