Provider Demographics
NPI:1265403828
Name:WILLIAMS BROS. HEALTH CARE PHARMACY, INC.
Entity type:Organization
Organization Name:WILLIAMS BROS. HEALTH CARE PHARMACY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
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 1:10 W. MAIN STREET
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:IN
Practice Address - Zip Code:47102
Practice Address - Country:US
Practice Address - Phone:812-794-4311
Practice Address - Fax:812-794-2514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IN60003256A3336C0003X
IN60006642A3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100301270AMedicaid
IN300008948Medicaid
2026395OtherPK