Dawn R Goodwin, RPH

Individual provider Active NPI Community/Retail Pharmacy · Fort Recovery, OH

NPI 1770645293 · NPPES record last updated Jul 13, 2020

Key facts

NPI
1770645293
Entity type
Individual (NPI type 1)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
030122789 (OH)
Practice address
102 N Wayne St
Fort Recovery, OH 45846-8059
Phone
(419) 375-2323
Fax
(419) 375-4488
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

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.

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
030122789OHMDCommunity/Retail Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Kaup Pharmacy, Inc. Community/Retail Pharmacy Past Accepting new patients
Jlkgt Investments LLC Community/Retail Pharmacy Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 030122789 OH Yes

Addresses

Primary practice location

102 N Wayne St
Fort Recovery, OH 45846-8059

Mailing address

102 N Wayne St
Fort Recovery, OH 45846-8059
Phone (419) 375-2323

Other providers in Fort Recovery, OH

All providers in Fort Recovery, OH · Community/Retail Pharmacy in Ohio

Sources for this page

Verify at the official NPI Registry.