Individual
DALE ALAN GODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
WALMART 3485, 2257 HWY 515, BLAIRSVILLE, GA 30512
(706) 835-2833
(706) 835-2840
Mailing address
699 DOCKERY CREEK RD, YOUNG HARRIS, GA 30582-3760
(706) 897-6836
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH018229
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH018229
GEORGIA PHARMACY LICENSE
GA
Enumeration date
11/09/2020
Last updated
11/09/2020
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