Healthcare Provider Details

I. General information

NPI: 1720114135
Provider Name (Legal Business Name): WILLIAMS APOTHECARY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 03/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E OREGON RD
LITITZ PA
17543-9205
US

IV. Provider business mailing address

1001 E OREGON RD
LITITZ PA
17543-9205
US

V. Phone/Fax

Practice location:
  • Phone: 717-581-3950
  • Fax: 717-581-3952
Mailing address:
  • Phone: 717-581-3950
  • Fax: 717-581-3952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPP415122L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier3974195
Identifier TypeOTHER
Identifier State
Identifier IssuerNCPDP PROVIDER IDENTIFICATION NUMBER
# 2
Identifier0011272920003
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: RICHARD WILLIAMS
Title or Position: PRES
Credential: RPH
Phone: 717-393-3814