Provider Demographics
NPI:1881009199
Name:WILLIAMS BROS. HEALTH CARE PHARMACY, INC.
Entity Type:Organization
Organization Name:WILLIAMS BROS. HEALTH CARE PHARMACY, INC.
Other - Org Name:WILLIAMS BROS. HEALTH CARE
Other - Org Type:Doing Business As
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, III
Authorized Official - Suffix:III
Authorized Official - Credentials:RPH
Authorized Official - Phone:812-254-2497
Mailing Address - Street 1:PO BOX 271
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47501-0271
Mailing Address - Country:US
Mailing Address - Phone:812-254-2497
Mailing Address - Fax:812-257-2592
Practice Address - Street 1:151 N GARDENMILE RD STE A
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-5543
Practice Address - Country:US
Practice Address - Phone:270-869-9197
Practice Address - Fax:270-844-8045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-25
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0221100014OtherMEDICARE NSC