Provider Demographics
NPI:1437439510
Name:WINDROSE HEALTH NETWORK, INC.
Entity Type:Organization
Organization Name:WINDROSE HEALTH NETWORK, INC.
Other - Org Name:WINDROSE HEALTH NETWORK - SOUTH INDY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:K
Authorized Official - Last Name:ROLLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-739-4895
Mailing Address - Street 1:14 TRAFALGAR SQ
Mailing Address - Street 2:
Mailing Address - City:TRAFALGAR
Mailing Address - State:IN
Mailing Address - Zip Code:46181-9515
Mailing Address - Country:US
Mailing Address - Phone:317-739-4895
Mailing Address - Fax:317-878-2355
Practice Address - Street 1:8921 SOUTHPOINTE DR STE A1
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-1085
Practice Address - Country:US
Practice Address - Phone:317-884-7820
Practice Address - Fax:317-888-8851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-22
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200127470EMedicaid
IN151855Medicare Oscar/Certification