Winnersville Long Term Care Packaging

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHRE0100063 Issued in GA

Legal business name

WINNERSVILLE LONG TERM CARE PACKAGING

Practice address

3782 Old US Highway 41 N
Suite B
Valdosta, GA 31602-6834

Phone

(229) 249-0100

Fax

(229) 219-1588

NPI assigned

Apr 25, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Troy Allen

Title

General Manager

Phone

(229) 249-0100

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• AmeriMed Long-Term Care Packaging Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481155200000",
    "number": "1609210202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4824",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316044824",
            "telephone_number": "229-249-0100",
            "fax_number": "229-219-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3782 OLD US HIGHWAY 41 N",
            "address_2": "SUITE B",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026834",
            "telephone_number": "229-249-0100",
            "fax_number": "229-219-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINNERSVILLE LONG TERM CARE PACKAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-25",
        "last_updated": "2016-12-08",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "229-249-0100"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "GA",
            "license": "PHRE0100063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2139900",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AmeriMed Long-Term Care Packaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caitlyn Elizabeth Wilson, OTR/L
• Nyle Kunyri Wilson, DDS
• Steven Michael Wilson, O.D.
• Shonta K Winbush, PA
• Jessica Wing
• Winnersville Pharmacy LLC
• Winnersville Pharmacy, LLC
• July Wise
• Marcie C Wiseman, PHD
• Chaeli Wisenbaker, PA-C

• Long Term Care Pharmacy in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Long Term Care Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.