1487483087 NPI number — WILLIAMS BROS. HEALTH CARE PHARMACY, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487483087 NPI number — WILLIAMS BROS. HEALTH CARE PHARMACY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAMS BROS. HEALTH CARE PHARMACY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487483087
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 271
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47501-0271
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-254-2497
Provider Business Mailing Address Fax Number:
812-257-2592

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1029 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OLNEY
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62450-2625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-254-2497
Provider Business Practice Location Address Fax Number:
812-257-2592
Provider Enumeration Date:
07/31/2024

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIAMS, III
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
CLAYBORNE
Authorized Official Title or Position:
CHIEF STRATEGY OFFICER
Authorized Official Telephone Number:
812-254-2497

Provider Taxonomy Codes

  • Taxonomy code: 3336L0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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