Williams Bros Health Care Pharmacy Inc

Organization Active NPI Community/Retail Pharmacy · Loogootee, IN

NPI 1093960437 · NPPES record last updated Aug 27, 2025

Key facts

NPI
1093960437
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
60006177A (IN)
Legal business name
WILLIAMS BROS HEALTH CARE PHARMACY INC
Practice address
104 E Broadway St
Loogootee, IN 47553-2007
Phone
(812) 295-4370
Fax
(812) 295-4383
NPI assigned
Nov 26, 2008
Organization subpart
No

Authorized official

Name
Charles Clayborne Williams III, R.PH
Title
Owner/Chief Strategy Officer
Phone
(812) 254-2497

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in IN

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Core of Dale
Dale, IN · CCN 155270
Skilled nursing facility Adp of the SNF Apr 1, 2008
Core of Bedford
Bedford, IN · CCN 155388
Skilled nursing facility Adp of the SNF Apr 1, 2008

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930087437 IN DME Supplier - Pharmacy
DME Supplier - Medical Supply Company With Orthotic Personnel
DME Supplier - Medical Supply Company With Prosthetic Personnel
DME Supplier - Medical Supply Company With Registered Pharmacist
DME Supplier - Oxygen & Equipment
7315064615 Practice locations: Loogootee, IN
O20110907001285 IN Part B Supplier - Mass Immunization (Roster Biller Only) 7315064615 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Washington, IN; Vincennes, IN; Princeton, IN; Paoli, IN; Loogootee, IN; Bloomington, IN; Austin, IN

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 60006177A IN Yes

Addresses

Primary practice location

104 E Broadway St
Loogootee, IN 47553-2007

Mailing address

104 E Broadway St
Loogootee, IN 47553-2007
Phone (812) 295-4370

Other identifiers

IdentifierTypeStateIssuer
2117989OtherPK
200923180AMedicaidIN

Other names

  • Williams Bros Health Care Pharmacy Doing business as
  • Williams Bros Health Care Pharmacy Inc Doing business as

Other providers in Loogootee, IN

All providers in Loogootee, IN · Community/Retail Pharmacy in Indiana

Sources for this page

Verify at the official NPI Registry.