Provider Demographics
NPI:1396282323
Name:GOODWIN, JULIA HALL (RPH)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:HALL
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1347 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:28337-9548
Mailing Address - Country:US
Mailing Address - Phone:910-862-8517
Mailing Address - Fax:910-862-8606
Practice Address - Street 1:1347 W BROAD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NC
Practice Address - Zip Code:28337-9548
Practice Address - Country:US
Practice Address - Phone:910-862-8517
Practice Address - Fax:910-862-8606
Is Sole Proprietor?:No
Enumeration Date:2017-01-29
Last Update Date:2017-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC08417183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist