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Organization
WILLIAMS LTC PHARMACY, LLC
Active
Organization
WILLIAMS LTC PHARMACY, LLC
Active
Other names
Williams LTC Pharmacy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES CLAYBORNE WILLIAMS III RPH (OWNER/CHIEF STRATEGY OFFICER)
(812) 254-2497
Entity
Organization
Contact information
Practice address
11900 EXIT 5 PKWY, FISHERS, IN 46037-7939
(317) 889-4125
(317) 889-4134
Mailing address
PO BOX 498, WASHINGTON, IN 47501-0498
(812) 254-2497
(812) 257-2592
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
203.001778
IL
332B00000X
Durable Medical Equipment & Medical Supplies
60006345A
IN
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
203.001778
IL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
60006345A
IN
3336H0001X
Home Infusion Therapy Pharmacy
054.018509
IL
3336H0001X
Home Infusion Therapy Pharmacy
60006345A
IN
3336H0001X
Home Infusion Therapy Pharmacy
NRP.022594950-03
OH
3336L0003X
Long Term Care Pharmacy
054.018509
IL
3336L0003X
Long Term Care Pharmacy
Primary
60006345A
IN
3336L0003X
Long Term Care Pharmacy
NRP.022594950-03
OH
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200446060A
—
IN
01
—
2142039
PK
—
Enumeration date
06/10/2006
Last updated
04/10/2024
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