Active NPI
Earl Glen Williams Jr., PHARM D
- Pharmacist
- Covington, LA
National Provider Identifier
1477876431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17129
- Practice address
- 71041 Highway 21
Covington, LA 70433-7120 - Phone
- (985) 875-0715
- Fax
- (985) 875-9728
- NPI assigned
- Mar 5, 2010
- Last updated
- Nov 17, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17129 | LA | Primary |
Addresses
Primary practice location
71041 Highway 21
Covington, LA 70433-7120
Mailing address
19705 Highway 40
Covington, LA 70435-9316
Phone (985) 674-7504
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17129 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lee Road Family Pharmacy Inc. | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Covington, LA
- NPI 1275918922
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1477876431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19705 HIGHWAY 40",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704359316",
"telephone_number": "985-674-7504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71041 HIGHWAY 21",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704337120",
"telephone_number": "985-875-0715",
"fax_number": "985-875-9728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "EARL",
"middle_name": "GLEN",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-05",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "17129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.