Provider Demographics
NPI:1437327921
Name:WILLIAMS BROS HEALTH CARE PHARMACY INC
Entity Type:Organization
Organization Name:WILLIAMS BROS HEALTH CARE PHARMACY INC
Other - Org Name:WILLIAMS BROS HEALTH CARE PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIEF STRATEGY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:CLAYBORNE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:III
Authorized Official - Credentials:RPH
Authorized Official - Phone:812-254-2497
Mailing Address - Street 1:10 WILLIAMS BROS DRIVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47501-4535
Mailing Address - Country:US
Mailing Address - Phone:812-254-2497
Mailing Address - Fax:812-257-2586
Practice Address - Street 1:1029 E MAIN ST
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:IL
Practice Address - Zip Code:62450-2625
Practice Address - Country:US
Practice Address - Phone:618-395-2144
Practice Address - Fax:618-392-5075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
IL0540163903336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2023652OtherPK
2023652OtherPK
2023652OtherPK