Provider Demographics
NPI:1669605440
Name:GOODMAN, COURTNEY FENWICK (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:FENWICK
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3054 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-7424
Mailing Address - Country:US
Mailing Address - Phone:615-794-6786
Mailing Address - Fax:
Practice Address - Street 1:3054 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-7424
Practice Address - Country:US
Practice Address - Phone:615-794-6786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist