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Organization
WINSLETTE PHARMACY INC
Active
Organization
WINSLETTE PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WOOTSON KEITH WINSLETTE R.PH. (PHARMACIST OWNER)
(706) 290-0300
Entity
Organization
Contact information
Practice address
2444 SHORTER AVE NW, ROME, GA 30165-1959
(706) 290-0300
(706) 290-0370
Mailing address
2444 SHORTER AVE NW, ROME, GA 30165-1959
(706) 290-0300
(706) 290-0370
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
GA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00713512A
—
GA
01
—
105073
MEDICAID DME
AL
01
—
105171
MEDICAID PHARMACY
AL
01
—
1142974
NABP NCPDP
GA
Enumeration date
12/13/2006
Last updated
11/06/2008
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