Healthcare Provider Details

I. General information

NPI: 1659319325
Provider Name (Legal Business Name): WINCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date: 06/30/2021
Reactivation Date: 07/15/2021

III. Provider practice location address

1558 S. WINSTEAD AVE
ROCKY MOUNT NC
27803-1650
US

IV. Provider business mailing address

PO BOX 7276
ROCKY MOUNT NC
27804-0276
US

V. Phone/Fax

Practice location:
  • Phone: 252-937-2080
  • Fax: 252-937-4660
Mailing address:
  • Phone: 252-937-2080
  • Fax: 252-937-4660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. AMY L RUDDICK
Title or Position: GENERAL MANAGER
Credential:
Phone: 252-937-2080