Organization
BILBRO CORPORATION
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
DENA FERMAN (THIRD PARTY PLAN COORDINATOR)
(314) 993-6000
Entity
Organization
Contact information
Practice address
1550 WATSON BLVD, WARNER ROBINS, GA 31093-3432
(478) 922-2067
(478) 922-5025
Mailing address
1550 WATSON BLVD, WARNER ROBINS, GA 31093-3432
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
006348
GA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00289264A
—
GA
01
—
1128405
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/15/2006
Last updated
03/07/2023
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