Healthcare Provider Details

I. General information

NPI: 1619345758
Provider Name (Legal Business Name): ALICIA WILLIAMS PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2015
Last Update Date: 11/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2177 KILLINGLY CMNS
KILLINGLY CT
06241-2188
US

IV. Provider business mailing address

97 CEMETERY RD
MANSFIELD CENTER CT
06250-1311
US

V. Phone/Fax

Practice location:
  • Phone: 860-412-1284
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPCT.0013409
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: