Provider Demographics
NPI:1033295704
Name:GODWIN, RHYS C SR
Entity Type:Individual
Prefix:MR
First Name:RHYS
Middle Name:C
Last Name:GODWIN
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 EDWARDS DR SE
Mailing Address - Street 2:SUITE F
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-1856
Mailing Address - Country:US
Mailing Address - Phone:770-845-4643
Mailing Address - Fax:
Practice Address - Street 1:3030 EDWARDS DR SE
Practice Address - Street 2:SUITE F
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-1856
Practice Address - Country:US
Practice Address - Phone:770-845-4643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies