Healthcare Provider Details

I. General information

NPI: 1740195924
Provider Name (Legal Business Name): JOHN WILLIAM WATERS III PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5268 US HIGHWAY 231
WETUMPKA AL
36092-3169
US

IV. Provider business mailing address

9055 HURON CT
PIKE ROAD AL
36064-2391
US

V. Phone/Fax

Practice location:
  • Phone: 334-567-5136
  • Fax: 334-567-5142
Mailing address:
  • Phone: 334-567-5136
  • Fax: 334-567-5142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberAL16182
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: