Provider Demographics
NPI:1922409515
Name:WILLIAMS PHARMACY
Entity Type:Organization
Organization Name:WILLIAMS PHARMACY
Other - Org Name:WILLIAMS PHARMACY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:678-761-3812
Mailing Address - Street 1:8697 HOSPITAL DR STE 201
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-2225
Mailing Address - Country:US
Mailing Address - Phone:678-695-7927
Mailing Address - Fax:678-695-7929
Practice Address - Street 1:8697 HOSPITAL DR STE 201
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-2225
Practice Address - Country:US
Practice Address - Phone:678-695-7927
Practice Address - Fax:678-695-7929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-15
Last Update Date:2014-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0235883336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy