Provider Demographics
NPI:1356626808
Name:NORBURY, WILLIAM J (RPH, MBA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:J
Last Name:NORBURY
Suffix:
Gender:M
Credentials:RPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SCOTCH PINE ST
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62234-2544
Mailing Address - Country:US
Mailing Address - Phone:618-346-7596
Mailing Address - Fax:
Practice Address - Street 1:8000 ST. CHARLES ROCK ROAD
Practice Address - Street 2:WALGREENS PHARMACY 4825
Practice Address - City:ST.LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63114
Practice Address - Country:US
Practice Address - Phone:314-426-1044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO028651183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist