MEDICARE: WILLIAMS BROS. HEALTH CARE PHARMACY, INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BX2000X	Oxygen Equipment & Supplies (DME)

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0221100014	OTHER	KY	MEDICARE NSC

General Provider Information

NPI Number	:	1881009199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAMS BROS. HEALTH CARE PHARMACY, INC.

Provider Business Mailing Address
First Line	:	PO BOX 271
Second Line	:
City	:	WASHINGTON
State	:	IN
Zip	:	47501-0271
Country	:	US
Telephone Number	:	812-254-2497
Fax Number	:	812-257-2592

Provider Business Practice Location Address
First Line	:	151 N GARDENMILE RD STE A
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420-5543
Country	:	US
Telephone Number	:	270-869-9197
Fax Number	:	270-844-8045

Authorized Official
Title or Position	:	OWNER/CHIEF STRATEGY OFFICER
Name	:	CHARLES CLAYBORNE WILLIAMS, III III
Credential	:	RPH
Telephone Number	:	812-254-2497

Provider Enumeration Date	:	06/25/2014
Last Update Date	:	05/02/2025

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