WINCARE, INC.

Provider Demographics

• NPI: 1659319325
• Name: WINCARE, INC.
• Entity Type: Organization
• Organization Name: WINCARE, INC.
• Authorized Official - Title/Position: GENERAL MANAGER
• Authorized Official - Prefix: MS
• Authorized Official - First Name: AMY
• Authorized Official - Middle Name: L
• Authorized Official - Last Name: RUDDICK
• Authorized Official - Phone: 252-937-2080
• Mailing Address - Street 1: PO BOX 7276
• Mailing Address - City: ROCKY MOUNT
• Mailing Address - State: NC
• Mailing Address - Zip Code: 27804-0276
• Mailing Address - Country: US
• Mailing Address - Phone: 252-937-2080
• Mailing Address - Fax: 252-937-4660
• Practice Address - Street 1: 1558 S. WINSTEAD AVE
• Practice Address - City: ROCKY MOUNT
• Practice Address - State: NC
• Practice Address - Zip Code: 27803-1650
• Practice Address - Country: US
• Practice Address - Phone: 252-937-2080
• Practice Address - Fax: 252-937-4660
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-06-03
• Last Update Date: 2023-04-24
• Deactivation Date: 2021-06-30
• Reactivation Date: 2021-07-15

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies		Group - Multi-Specialty
No	363LA2200X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Adult Health	Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
	0467F	Other	BLUE CROSS BLUE SHIELD FEDERAL
KS	100347340A	Medicaid
KS	7586819301	Medicaid
NC	7702534	Medicaid
VA	009107231	Medicaid
NC	0467F	Other	BLUE CROSS BLUE SHIELD OF NC
VA	263113	Other	ANTHEM BLUE CROSS BLUE SH
	0467F	Other	BLUE CROSS BLUE SHIELD FE
SC	DM1152	Medicaid
NC	0467F	Other	BLUE CROSS BLUE SHIELD
NC	0467F	Other	STATE OF NC TEACHERS AND
VA	263113	Other	ANTHEM BLUE CROSS BLUE SHIELD OF VA
NC	0467F	Other	STATE OF NC TEACHERS AND STATE EMPLOYEES
NC	0467F	Other	BLUE CROSS BLUE SHIELD
NC	2075495	Medicare PIN
SC	DM1152	Medicaid