Provider Demographics
NPI:1598249336
Name:WILLIAMS, CAMERON JOSEPH (RPH)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:JOSEPH
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2475 STATE ROUTE 130
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-3958
Mailing Address - Country:US
Mailing Address - Phone:724-961-2576
Mailing Address - Fax:
Practice Address - Street 1:314 E PITTSBURGH ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2602
Practice Address - Country:US
Practice Address - Phone:724-834-0960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP452749183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist