Brock, Winston B

Brock, Winston B is an sole proprietor health care provider with primary practice located at 1205 E Shotwell St , Bainbridge GA 39819-4237. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Brock, Winston B can be contacted via phone (229) 246-1000.

Contact Information

Primary practice address
1205 E Shotwell St Bainbridge GA 39819-4237
Fax: (229) 246-5643
Website:

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X PHRE006828 Georgia

Profile Details

NPI number 1770602310
LBN Legal business name Brock, Winston B
Credentials RPH
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 28th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770602310 NPPES
Georgia MEDICAID 55003547A

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