Provider Demographics
NPI:1063532919
Name:WILLIAMS, MARY A (PHARMACIST)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:A
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:315 WYANDOT ST
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29532-4234
Mailing Address - Country:US
Mailing Address - Phone:843-393-2396
Mailing Address - Fax:
Practice Address - Street 1:203 S MAIN ST
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:SC
Practice Address - Zip Code:29532-3953
Practice Address - Country:US
Practice Address - Phone:843-395-6020
Practice Address - Fax:843-395-2595
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist