Healthcare Provider Details

I. General information

NPI: 1366475113
Provider Name (Legal Business Name): WILLIAMS BROS HEALTH CARE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1216 WASHINGTON AVE
VINCENNES IN
47591-2245
US

IV. Provider business mailing address

10 WILLIAMS BROS DRIVE
WASHINGTON IN
47501-4535
US

V. Phone/Fax

Practice location:
  • Phone: 812-882-1800
  • Fax: 812-886-4042
Mailing address:
  • Phone: 812-254-2497
  • Fax: 812-257-2586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number60006379A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number054.018711
License Number StateIL

VIII. Authorized Official

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