Healthcare Provider Details

I. General information

NPI: 1336569441
Provider Name (Legal Business Name): MARCIA MICHELLE GOODWIN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2014
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 N MAIN ST
SUMMERVILLE SC
29483-7342
US

IV. Provider business mailing address

1745 OLD WHITESVILLE RD
MONCKS CORNER SC
29461-2766
US

V. Phone/Fax

Practice location:
  • Phone: 843-821-1360
  • Fax:
Mailing address:
  • Phone: 843-469-8562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13407
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: