Active NPI
Clifford Dowling Goodman II, RPH
- Pharmacist
- Blountstown, FL
National Provider Identifier
1750423331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS12630
- Practice address
- 17324 Main St N
Blountstown, FL 32424-1763 - Phone
- (850) 674-4557
- Fax
- (850) 674-4568
- NPI assigned
- Feb 12, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS12630 | FL | Primary |
Addresses
Primary practice location
17324 Main St N
Blountstown, FL 32424-1763
Mailing address
17324 Main St N
Blountstown, FL 32424-1763
Phone (850) 674-8429
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS12630 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Golden Pharmacy,Inc | Current | Accepting new patients |
Locations
17324 Main St N
Blountstown, FL 32424
Phone (850) 674-4557
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacy
- Blountstown, FL
- NPI 1174624365
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750423331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17324 MAIN ST N",
"city": "BLOUNTSTOWN",
"state": "FL",
"postal_code": "324241763",
"telephone_number": "850-674-8429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17324 MAIN ST N",
"city": "BLOUNTSTOWN",
"state": "FL",
"postal_code": "324241763",
"telephone_number": "850-674-4557",
"fax_number": "850-674-4568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "CLIFFORD",
"middle_name": "DOWLING",
"name_suffix": "II",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS12630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blountstown, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.