Dale Alan Godwin, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH018229 Issued in GA

Practice address

Walmart 3485
2257 Hwy 515
Blairsville, GA 30512

Phone

(706) 835-2833

Fax

(706) 835-2840

NPI assigned

Nov 9, 2020

Last updated

Nov 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dalgodwi.s02753.us@wal-mart.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wal-Mart Stores East LP

  dba WalMart Pharmacy 10-3485

  • Community/Retail Pharmacy
  • Blairsville, GA
  • NPI 1649407552
  NPD (past)
• Wal-Mart Stores East, LP

  dba Walmart Pharmacy 10-2229

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1720680473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 DOCKERY CREEK RD",
            "city": "YOUNG HARRIS",
            "state": "GA",
            "postal_code": "305823760",
            "telephone_number": "706-897-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WALMART 3485",
            "address_2": "2257 HWY 515",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "30512",
            "telephone_number": "706-835-2833",
            "fax_number": "706-835-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODWIN",
        "first_name": "DALE",
        "middle_name": "ALAN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH018229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA PHARMACY LICENSE",
            "identifier": "RPH018229",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dalgodwi.s02753.us@wal-mart.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Work",
            "address_1": "Walmart 3485",
            "address_2": "2257 Hwy 515",
            "city": "Blairsville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pharmacist in Blairsville, GA
• Providers in Blairsville, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.