Provider Demographics
NPI:1467129957
Name:WILLIAMS, RILEY GLEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RILEY
Middle Name:GLEE
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:208 CHIPPEWA DR STE 110
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-1380
Mailing Address - Country:US
Mailing Address - Phone:270-535-9990
Mailing Address - Fax:270-651-1183
Practice Address - Street 1:415 S L ROGERS WELLS BLVD
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-1191
Practice Address - Country:US
Practice Address - Phone:270-615-7948
Practice Address - Fax:270-615-1183
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY019399183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist