Healthcare Provider Details
I. General information
NPI: 1992738686
Provider Name (Legal Business Name): WB DRUGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2006
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1205 E SHOTWELL ST
BAINBRIDGE GA
39819-4237
US
IV. Provider business mailing address
1205 E SHOTWELL ST STE A
BAINBRIDGE GA
39819-4237
US
V. Phone/Fax
- Phone: 229-246-1000
- Fax: 229-246-5643
- Phone: 229-246-1000
- Fax: 229-246-5643
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | PHRE006828 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | PHRE006828 |
| License Number State | GA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | PHRE006828 |
| License Number State | GA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | PHRE006828 |
| License Number State | GA |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PHRE006828 |
| License Number State | GA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | PHRE006828 |
| License Number State | GA |
VIII. Authorized Official
Name:
WINSTON
BROCK
Title or Position: PRESIDENT
Credential:
Phone: 229-246-1000