Goodwill Community Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482421 Issued in PA

Legal business name

GOODWILL COMMUNITY PHARMACY LLC

Practice address

5002 Wayne Ave
Philadelphia, PA 19144-3642

Phone

(267) 385-5554

Fax

(267) 385-5485

NPI assigned

Feb 19, 2014

Last updated

Apr 1, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Uche Davis

Title

Owner

Phone

(267) 385-5458

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585699200000",
    "number": "1689099202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 WAYNE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191443642",
            "telephone_number": "267-385-5554",
            "fax_number": "267-385-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 WAYNE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191443642",
            "telephone_number": "267-385-5554",
            "fax_number": "267-385-5485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWILL COMMUNITY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-19",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "UCHE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-385-5458"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029378990001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larkerra Goodson, CPS
• Michele Goodson, CRNP
• Brooke L Goodspeed, CRNP
• Noel M Goodstadt, PT, DPT, OCS, CSCS
• Dennis Charles Goodstein, PHARMD
• Amy Lesher Goodwin, PA-C
• David Goodwin, PHD
• Jeanimarie Goodwin
• Joi Elizabeth Goodwin, CRNP
• Michele M. Goodwin, CRNP

• Community/Retail Pharmacy in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.