Healthcare Provider Details

I. General information

NPI: 1184767709
Provider Name (Legal Business Name): GRETA LOCKHART WILLIAMS BS PHARMACY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 N PAULINE ST FL 4 COMMUNITY BEHAVIORAL HEALTH
MEMPHIS TN
38105-4619
US

IV. Provider business mailing address

7395 COTTON PLANT CV
MEMPHIS TN
38119-8950
US

V. Phone/Fax

Practice location:
  • Phone: 901-577-6167
  • Fax: 901-577-6180
Mailing address:
  • Phone: 901-758-0198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number8296
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: