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NPI Code Detail

MEDICARE: DAWN R GOODWIN RPH

MEDICARE: DAWN R GOODWIN RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy030122789OH

General Provider Information

NPI Number : 1770645293
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAWN R GOODWIN RPH
Provider Business Mailing Address
First Line : 102 N WAYNE ST
Second Line :
City : FORT RECOVERY
State : OH
Zip : 45846-8059
Country : US
Telephone Number : 419-375-2323
Fax Number : 419-375-4488
Provider Business Practice Location Address
First Line : 102 N WAYNE ST
Second Line :
City : FORT RECOVERY
State : OH
Zip : 45846-8059
Country : US
Telephone Number : 419-375-2323
Fax Number : 419-375-4488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2006
Last Update Date : 07/13/2020

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