Provider Demographics
NPI:1386059871
Name:WILLIAMS, RUBIE
Entity type:Individual
Prefix:
First Name:RUBIE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-3548
Mailing Address - Country:US
Mailing Address - Phone:803-920-9343
Mailing Address - Fax:803-753-9391
Practice Address - Street 1:1700 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:SC
Practice Address - Zip Code:29108-3548
Practice Address - Country:US
Practice Address - Phone:803-920-9343
Practice Address - Fax:803-753-9391
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health