Active NPI
Winslette Pharmacy Inc
- Pharmacy
- Rome, GA
National Provider Identifier
1649331265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- Legal business name
- WINSLETTE PHARMACY INC
- Practice address
- 2444 Shorter Ave NW
Rome, GA 30165-1959 - Phone
- (706) 290-0300
- Fax
- (706) 290-0370
- NPI assigned
- Dec 13, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Wootson Keith Winslette, R.PH.
- Title
- Pharmacist Owner
- Phone
- (706) 290-0300
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | GA | ||
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | |||
| Pharmacy | 333600000X | Primary | ||
| Compounding Pharmacy | 3336C0004X | |||
| Home Infusion Therapy Pharmacy | 3336H0001X |
Addresses
Primary practice location
2444 Shorter Ave NW
Rome, GA 30165-1959
Mailing address
2444 Shorter Ave NW
Rome, GA 30165-1959
Phone (706) 290-0300
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00713512A | Medicaid | GA | |
| 105073 | Other | AL | MEDICAID DME |
| 1142974 | Other | GA | NABP NCPDP |
| 105171 | Other | AL | MEDICAID PHARMACY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190315002585 | GA | Part B Supplier - Pharmacy | 1557436292 | Practice locations: Rome, GA |
National Provider Directory
National Provider DirectoryLocations
2444 Shorter Ave NW
Rome, GA 30165
Phone (706) 290-0300
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Rome, GA
- NPI 1467030551
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1225929600000",
"number": "1649331265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2444 SHORTER AVE NW",
"city": "ROME",
"state": "GA",
"postal_code": "301651959",
"telephone_number": "706-290-0300",
"fax_number": "706-290-0370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2444 SHORTER AVE NW",
"city": "ROME",
"state": "GA",
"postal_code": "301651959",
"telephone_number": "706-290-0300",
"fax_number": "706-290-0370"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WINSLETTE PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-13",
"last_updated": "2008-11-06",
"status": "A",
"authorized_official_last_name": "WINSLETTE",
"authorized_official_first_name": "WOOTSON",
"authorized_official_middle_name": "KEITH",
"authorized_official_title_or_position": "PHARMACIST OWNER",
"authorized_official_telephone_number": "706-290-0300",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "R.PH."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "GA",
"license": null,
"primary": false
},
{
"code": "332BP3500X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336H0001X",
"taxonomy_group": "",
"desc": "Pharmacy, Home Infusion Therapy Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00713512A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID DME",
"identifier": "105073",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP NCPDP",
"identifier": "1142974",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID PHARMACY",
"identifier": "105171",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rome, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.