Provider Demographics
NPI:1295952166
Name:WILLIAMS, MAC A (RPH)
Entity type:Individual
Prefix:MR
First Name:MAC
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:RPH
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Mailing Address - Street 1:235 S HARRISON ST
Mailing Address - Street 2:207
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-1463
Mailing Address - Country:US
Mailing Address - Phone:973-672-4094
Mailing Address - Fax:973-672-4094
Practice Address - Street 1:2250 HICKORY RD
Practice Address - Street 2:SUITE 240
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1047
Practice Address - Country:US
Practice Address - Phone:800-879-4471
Practice Address - Fax:610-834-7525
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ28RI01619300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist