MEDICARE: DR. REBECCA FAYE WILLIAMS PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	023265	GA

General Provider Information

NPI Number	:	1114092129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECCA FAYE WILLIAMS PHARMD

Provider Business Mailing Address
First Line	:	478 BAILEY LN
Second Line	:
City	:	ELLAVILLE
State	:	GA
Zip	:	31806-9356
Country	:	US
Telephone Number	:	229-942-7781
Fax Number	:

Provider Business Practice Location Address
First Line	:	560 S. BROAD ST
Second Line	:
City	:	ELLAVILLE
State	:	GA
Zip	:	31806
Country	:	US
Telephone Number	:	229-937-3352
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	01/08/2015

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