Provider Demographics
NPI:1235108796
Name:WILLIAMS, BEVERLY H (RPH, PHARM D)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:H
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RPH, PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 W WOODROW WILSON AVE STE 311
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39213-7681
Mailing Address - Country:US
Mailing Address - Phone:601-487-2281
Mailing Address - Fax:601-362-6325
Practice Address - Street 1:350 W WOODROW WILSON AVE STE 311
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39213-7681
Practice Address - Country:US
Practice Address - Phone:601-487-2218
Practice Address - Fax:601-362-6325
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS7545183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist