Provider Demographics
NPI:1669206298
Name:THE C. W. WILLIAMS COMMUNITY HEALTH CENTER PHARMACY
Entity type:Organization
Organization Name:THE C. W. WILLIAMS COMMUNITY HEALTH CENTER PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:ALDEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-628-5263
Mailing Address - Street 1:5800 OLD PINEVILLE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-4106
Mailing Address - Country:US
Mailing Address - Phone:704-393-7720
Mailing Address - Fax:704-398-3173
Practice Address - Street 1:5800 OLD PINEVILLE RD STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-4106
Practice Address - Country:US
Practice Address - Phone:704-393-7720
Practice Address - Fax:704-398-3173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy