NPIMap

Organization Active NPI

WB Drugs, Inc.

Doing business as brock's vital care

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Bainbridge, GA
National Provider Identifier
1922033075
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X
License
PHRE006828 Issued in GA
Legal business name
WB DRUGS, INC.
Doing business as
brock's vital care
Practice address
1205 E Shotwell St
Bainbridge, GA 39819-4237
Phone
(229) 246-1000
Fax
(229) 246-5643
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Authorized official

Name
Winston BrockNPI 1770602310
Title
President
Phone
(229) 246-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X PHRE006828 GA Primary

Addresses

Primary practice location

1205 E Shotwell St
Bainbridge, GA 39819-4237

Mailing address

1205 E Shotwell St
Ste a
Bainbridge, GA 39819-4237
Phone (229) 246-1000

Other identifiers 3

IdentifierTypeStateIssuer
00395392AMedicaidGA
00395392BMedicaidGA
0243542-001OtherGABCBS

Other names 1

  • brock's vital care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
RX Drug Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1205 E Shotwell St
Bainbridge, GA 39819
Phone (229) 246-1000

Practitioners & affiliated clinicians

Practitioners 2

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": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1922033075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 E SHOTWELL ST",
            "address_2": "STE A",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194237",
            "telephone_number": "229-246-1000",
            "fax_number": "229-246-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 E SHOTWELL ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194237",
            "telephone_number": "229-246-1000",
            "fax_number": "229-246-5643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WB DRUGS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A",
        "authorized_official_last_name": "BROCK",
        "authorized_official_first_name": "WINSTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-246-1000"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "GA",
            "license": "PHRE006828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00395392A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00395392B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0243542-001",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "brock's vital care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "brock's vital care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bainbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.