Provider Demographics
NPI:1083169015
Name:WILLIAMS, HORACE JR (RPH)
Entity Type:Individual
Prefix:DR
First Name:HORACE
Middle Name:
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 S FAIR OAKS AVE
Mailing Address - Street 2:#200
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-4130
Mailing Address - Country:US
Mailing Address - Phone:626-449-0099
Mailing Address - Fax:626-449-7388
Practice Address - Street 1:257 S FAIR OAKS AVE
Practice Address - Street 2:#200
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-4130
Practice Address - Country:US
Practice Address - Phone:626-449-0099
Practice Address - Fax:626-449-7388
Is Sole Proprietor?:No
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23311183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist