Healthcare Provider Details

I. General information

NPI: 1700942026
Provider Name (Legal Business Name): GEORGE SCOTT GODFEY R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 GOODYEAR AVE
GADSDEN AL
35903-1133
US

IV. Provider business mailing address

179 FOX CHASE DR
HOKES BLUFF AL
35903-4591
US

V. Phone/Fax

Practice location:
  • Phone: 256-492-6594
  • Fax: 256-494-5062
Mailing address:
  • Phone: 256-492-0226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9484
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: