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General NPI Number Information
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NPI Number | 1942580436
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Entity Type | Individual
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Provider Name | LYNNE ANN WILLIAMS R.PH.
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Gender | Female
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Dates
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Enumeration Date | 08/28/2011
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Last Update Date | 08/28/2011
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Provider Practice Location Address
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Address Line | 9320 LACKLAND RD
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City | OVERLAND
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State | MO
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Zip | 63114-5458
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Country | US
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Telephone | 314-429-4636
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Fax | 314-429-8664
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Provider Business Mailing Address
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Address Line | 3204 HAWK DR
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City | SAINT CHARLES
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State | MO
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Zip | 63301-3706
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Country | US
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Telephone | 314-429-4636
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Fax | 314-429-8664
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 042476
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License Number State | MO
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