Provider Demographics
NPI:1720114135
Name:WILLIAMS APOTHECARY INC
Entity Type:Organization
Organization Name:WILLIAMS APOTHECARY INC
Other - Org Name:WILLIAMS APOTHECARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:717-393-3814
Mailing Address - Street 1:1001 E OREGON RD
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-9205
Mailing Address - Country:US
Mailing Address - Phone:717-581-3950
Mailing Address - Fax:717-581-3952
Practice Address - Street 1:1001 E OREGON RD
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-9205
Practice Address - Country:US
Practice Address - Phone:717-581-3950
Practice Address - Fax:717-581-3952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
PAPP415122L3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3974195OtherNCPDP PROVIDER IDENTIFICATION NUMBER
PA0011272920003Medicaid