Provider Demographics
NPI:1952300931
Name:WILLIAMS, VICKI SHAMBLEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VICKI
Middle Name:SHAMBLEN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 AMERICANA LN
Mailing Address - Street 2:
Mailing Address - City:HEDGESVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25427-7326
Mailing Address - Country:US
Mailing Address - Phone:410-212-4365
Mailing Address - Fax:304-754-0069
Practice Address - Street 1:71 COWARDLY LION DR
Practice Address - Street 2:
Practice Address - City:HEDGESVILLE
Practice Address - State:WV
Practice Address - Zip Code:25427-6785
Practice Address - Country:US
Practice Address - Phone:304-754-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD151891835P1200X
WVRP00062781835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy