# FORT WILLIAMS PHARMACY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fort Williams Pharmacy LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689808917
- **Authorized official:** CHAD LIGHTSEY (OWNER)
- **Authorized official phone:** (256) 404-6165

## Contact information

- **Practice address:** 401 W FORT WILLIAMS ST, SYLACAUGA, AL 35150-2435
- **Practice address phone:** (256) 207-2007
- **Practice address fax:** (256) 207-2008
- **Mailing address:** 401 W FORT WILLIAMS ST, SYLACAUGA, AL 35150-2435
- **Mailing address phone:** (256) 207-2007
- **Mailing address fax:** (256) 207-2008

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 113273 | AL | Yes |

## Other

- **Enumeration date:** 05/14/2009
- **Last updated:** 02/16/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2120344 | PK | — |