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NPI Code Detail

MEDICARE: TRICIA LYNN WILLIAMSON RPH

MEDICARE: TRICIA LYNN WILLIAMSON RPH
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
1183500000XPharmacist0051-286115IL

General Provider Information

NPI Number : 1538377262
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRICIA LYNN WILLIAMSON RPH
Provider Business Mailing Address
First Line : 302 W ILLINOIS ST
Second Line :
City : TRENTON
State : IL
Zip : 62293-1118
Country : US
Telephone Number : 618-224-7496
Fax Number : 618-398-5582
Provider Business Practice Location Address
First Line : 12 N 64TH ST STE 6
Second Line :
City : BELLEVILLE
State : IL
Zip : 62223-3809
Country : US
Telephone Number : 618-398-5127
Fax Number : 618-398-5582
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 07/08/2007

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Directions to “ TRICIA LYNN WILLIAMSON RPH” Practice Location

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