Provider Demographics
NPI:1386816619
Name:GOODWIN, MEREDITH ANNE (RPH)
Entity Type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:ANNE
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:ANNE
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:353 RTE 202-206
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2442
Mailing Address - Country:US
Mailing Address - Phone:908-722-8123
Mailing Address - Fax:908-722-6859
Practice Address - Street 1:353 RTE 202-206
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2442
Practice Address - Country:US
Practice Address - Phone:908-722-8123
Practice Address - Fax:908-722-6859
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28R101779100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist