Provider Demographics
NPI:1639172349
Name:WILLIAMS, CASEY BENJAMIN (PHARMD, BCOP)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:BENJAMIN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHARMD, BCOP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E 23RD ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-2108
Mailing Address - Country:US
Mailing Address - Phone:605-322-3588
Mailing Address - Fax:605-322-6901
Practice Address - Street 1:1000 E 23RD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-2108
Practice Address - Country:US
Practice Address - Phone:605-322-3588
Practice Address - Fax:605-322-6901
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR59201835P0018X
NDRPH54721835P0018X
KS1-138481835P1200X, 1835X0200X
NC154811835P1200X, 1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835X0200XPharmacy Service ProvidersPharmacistOncology