Healthcare Provider Details

I. General information

NPI: 1487621553
Provider Name (Legal Business Name): WILLIAMS BROS. HEALTH CARE PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

574 S LANDMARK AVE
BLOOMINGTON IN
47403-3239
US

IV. Provider business mailing address

10 WILLIAMS BROS DRIVE
WASHINGTON IN
47501-4535
US

V. Phone/Fax

Practice location:
  • Phone: 812-335-0000
  • Fax: 812-335-6311
Mailing address:
  • Phone: 812-254-2497
  • Fax: 812-257-2586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number60005677
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CHARLES CLAYBORNE WILLIAMS III
Title or Position: OWNER/CHIEF STRATEGY OFFICER
Credential: RPH
Phone: 812-254-2497