Provider Demographics
NPI:1922033075
Name:WB DRUGS, INC.
Entity Type:Organization
Organization Name:WB DRUGS, INC.
Other - Org Name:BROCK'S VITAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:
Authorized Official - Last Name:BROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-246-1000
Mailing Address - Street 1:1205 E SHOTWELL ST
Mailing Address - Street 2:STE A
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39819-4237
Mailing Address - Country:US
Mailing Address - Phone:229-246-1000
Mailing Address - Fax:229-246-5643
Practice Address - Street 1:1205 E SHOTWELL ST
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39819-4237
Practice Address - Country:US
Practice Address - Phone:229-246-1000
Practice Address - Fax:229-246-5643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE006828332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00395392AMedicaid
GA00395392BMedicaid
GA0243542-001OtherBCBS
GA00395392AMedicaid
0437360001Medicare NSC