Organization
WB DRUGS, INC.
Active
Other names
brock's vital care
Organization subpart
No
Provider details
NPI number
Authorized official
WINSTON BROCK (PRESIDENT)
(229) 246-1000
Entity
Organization
Contact information
Practice address
1205 E SHOTWELL ST, BAINBRIDGE, GA 39819-4237
(229) 246-1000
(229) 246-5643
Mailing address
1205 E SHOTWELL ST, STE A, BAINBRIDGE, GA 39819-4237
(229) 246-1000
(229) 246-5643
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
PHRE006828
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00395392A
—
GA
05
—
00395392B
—
GA
01
—
0243542-001
BCBS
GA
Enumeration date
07/11/2006
Last updated
12/16/2022
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