MEDICARE: DR. SHANDRIKA RICHELLE WILLIAMS PHARM.D.

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	18585	LA

General Provider Information

NPI Number	:	1184937856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANDRIKA RICHELLE WILLIAMS PHARM.D.

Provider Business Mailing Address
First Line	:	1 DREXEL DR
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70125-1056
Country	:	US
Telephone Number	:	504-520-6732
Fax Number	:

Provider Business Practice Location Address
First Line	:	4626 ALCEE FORTIER BLVD
Second Line	:	SUITE D
City	:	NEW ORLEANS
State	:	LA
Zip	:	70129-2130
Country	:	US
Telephone Number	:	504-255-8665
Fax Number	:	504-255-6447

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

Provider Enumeration Date	:	07/22/2010
Last Update Date	:	07/22/2010

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