Provider Demographics
NPI:1497732028
Name:WILLIAMS BROS. HEALTH CARE PHARMACY, INC.
Entity Type:Organization
Organization Name:WILLIAMS BROS. HEALTH CARE PHARMACY, INC.
Other - Org Name:
Other - Org Type:
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:R PH
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:812-257-2507
Practice Address - Street 1:10 WILLIAMS BROTHERS DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-4535
Practice Address - Country:US
Practice Address - Phone:812-254-2497
Practice Address - Fax:812-257-2507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-23
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251F00000X
332B00000X, 333600000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No251F00000XAgenciesHome Infusion
No333600000XSuppliersPharmacy
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100309120Medicaid
1525421OtherNABP
IN60003736OtherPHARMACY
IN0221100001Medicare NSC