Provider Demographics
NPI:1447603022
Name:WINNIE COMMUNITY HOSPITAL LLC
Entity Type:Organization
Organization Name:WINNIE COMMUNITY HOSPITAL LLC
Other - Org Name:RICELAND MEDICAL CENTER (AND CLINICS)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:YANCY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:409-296-6000
Mailing Address - Street 1:538 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WINNIE
Mailing Address - State:TX
Mailing Address - Zip Code:77665-7600
Mailing Address - Country:US
Mailing Address - Phone:409-296-6000
Mailing Address - Fax:409-296-8603
Practice Address - Street 1:1350 HIGHWAY 327 E
Practice Address - Street 2:
Practice Address - City:SILSBEE
Practice Address - State:TX
Practice Address - Zip Code:77656-6114
Practice Address - Country:US
Practice Address - Phone:409-385-7744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX352582ZPQZOtherMEDICARE PTAN