Provider Demographics
NPI:1578157509
Name:BEBELL, WILLIAM REILLY
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:REILLY
Last Name:BEBELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 CELLINI PL
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NC
Mailing Address - Zip Code:28120-9360
Mailing Address - Country:US
Mailing Address - Phone:954-261-6611
Mailing Address - Fax:
Practice Address - Street 1:525 CELLINI PL
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NC
Practice Address - Zip Code:28120-9360
Practice Address - Country:US
Practice Address - Phone:954-261-6611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-20
Last Update Date:2021-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28508183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist