Provider Demographics
NPI:1427019991
Name:SPECIALTY HOSPITAL OF WINNFIELD, INC.
Entity Type:Organization
Organization Name:SPECIALTY HOSPITAL OF WINNFIELD, INC.
Other - Org Name:SPECIALTY HOSPITAL OF WINNFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY / TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:MEANS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:318-742-3408
Mailing Address - Street 1:915 1ST ST
Mailing Address - Street 2:
Mailing Address - City:WINNFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:71483-2945
Mailing Address - Country:US
Mailing Address - Phone:318-648-0212
Mailing Address - Fax:318-648-1316
Practice Address - Street 1:915 1ST ST
Practice Address - Street 2:
Practice Address - City:WINNFIELD
Practice Address - State:LA
Practice Address - Zip Code:71483-2945
Practice Address - Country:US
Practice Address - Phone:318-648-0212
Practice Address - Fax:318-648-1316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2013-05-28
Deactivation Date:2013-05-08
Deactivation Code:
Reactivation Date:2013-05-28
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
61328OtherBLUE CROSS
192052Medicare ID - Type Unspecified