Provider Demographics
NPI:1326929662
Name:WINLACE MEDICAL SUPPLIES
Entity type:Organization
Organization Name:WINLACE MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WINIFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-703-0097
Mailing Address - Street 1:300 LESTER MILL RD STE 160
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:GA
Mailing Address - Zip Code:30248-5311
Mailing Address - Country:US
Mailing Address - Phone:770-284-3219
Mailing Address - Fax:770-564-8780
Practice Address - Street 1:300 LESTER MILL RD STE 160
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-5311
Practice Address - Country:US
Practice Address - Phone:770-284-3219
Practice Address - Fax:770-564-8780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies