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General NPI Number Information
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NPI Number | 1134359805
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Entity Type | Organization
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Legal Business Name | DAVID M WILLIAMS ENTERPRISES, LLC
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Dates
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Enumeration Date | 07/16/2009
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1824 59TH ST W
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City | BRADENTON
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State | FL
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Zip | 34209-4630
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Country | US
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Telephone | 941-794-2026
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Fax | 941-794-2446
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Provider Business Mailing Address
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Address Line | PO BOX 14003
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City | BRADENTON
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State | FL
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Zip | 34280-4003
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Country | US
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Telephone | 941-794-2026
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Fax | 941-794-2446
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Authorized Official
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Title or Position | PHARMACIST / PRESIDENT
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Name | MR. SCOTT A NICHOLS
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Credential | RPH
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Telephone | 941-524-7056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH24132
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License Number State | FL
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