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
—
—
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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