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NPI Code Detail

MEDICARE: KELLIE WILLIAMS

MEDICARE: KELLIE WILLIAMS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist5302041523MI
2183500000XPharmacist03236618OH

General Provider Information

NPI Number : 1033653688
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLIE WILLIAMS
Provider Business Mailing Address
First Line : 500 E CHICAGO ST
Second Line :
City : COLDWATER
State : MI
Zip : 49036-2042
Country : US
Telephone Number : 517-278-8272
Fax Number :
Provider Business Practice Location Address
First Line : 500 E CHICAGO ST
Second Line :
City : COLDWATER
State : MI
Zip : 49036-2042
Country : US
Telephone Number : 517-278-8272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2016
Last Update Date : 12/15/2016

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Directions to “ KELLIE WILLIAMS ” Practice Location

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