Michael Godwin, RPH.

Individual provider Active NPI Pharmacist · Cheraw, SC

NPI 1114283264 · NPPES record last updated Apr 3, 2012

Key facts

NPI
1114283264
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
5636 (SC)
Practice address
3825 Orchard Rd
Cheraw, SC 29520-5694
Phone
(843) 910-4634
NPI assigned
Apr 3, 2012
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5636SCMDSurgical Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5636 SC Yes

Addresses

Primary practice location

3825 Orchard Rd
Cheraw, SC 29520-5694

Mailing address

3825 Orchard Rd
Cheraw, SC 29520-5694

Other providers in Cheraw, SC

All providers in Cheraw, SC · Pharmacist in South Carolina

Sources for this page

Verify at the official NPI Registry.