Organization Active NPI

Winslette Pharmacy Inc

  • Pharmacy
  • Rome, GA
National Provider Identifier
1649331265
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
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

Updated by the provider on Nov 6, 2008

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00713512AMedicaidGA
105073OtherALMEDICAID DME
1142974OtherGANABP NCPDP
105171OtherALMEDICAID PHARMACY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190315002585 GA Part B Supplier - Pharmacy 1557436292 Practice locations: Rome, GA

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.