Provider Demographics
NPI:1669592317
Name:WAUGH, WILLIAM C JR (RPH)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:WAUGH
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1029
Mailing Address - Street 2:
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34430-1029
Mailing Address - Country:US
Mailing Address - Phone:352-489-5855
Mailing Address - Fax:
Practice Address - Street 1:10051 S US HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:DUNNELLON
Practice Address - State:FL
Practice Address - Zip Code:34432-4190
Practice Address - Country:US
Practice Address - Phone:352-465-2002
Practice Address - Fax:352-465-2003
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0011345183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist