Provider Demographics
NPI:1285529701
Name:TCGOODRICH CORPORATION
Entity type:Organization
Organization Name:TCGOODRICH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMRA
Authorized Official - Middle Name:CONNIE
Authorized Official - Last Name:GOODRICH
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, MHA
Authorized Official - Phone:385-406-4044
Mailing Address - Street 1:3374 N 700 W
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84414-2169
Mailing Address - Country:US
Mailing Address - Phone:385-406-4044
Mailing Address - Fax:385-406-4045
Practice Address - Street 1:648 N 900 E
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-2444
Practice Address - Country:US
Practice Address - Phone:385-406-4044
Practice Address - Fax:385-406-4044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care