Provider Demographics
NPI:1619064268
Name:WINSLOW MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:WINSLOW MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT MEDICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BROSSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:812-789-8880
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:IN
Mailing Address - Zip Code:47598-0070
Mailing Address - Country:US
Mailing Address - Phone:812-789-8880
Mailing Address - Fax:812-789-8883
Practice Address - Street 1:2206 S STATE ROAD 61
Practice Address - Street 2:
Practice Address - City:WINSLOW
Practice Address - State:IN
Practice Address - Zip Code:47598-8331
Practice Address - Country:US
Practice Address - Phone:812-789-8880
Practice Address - Fax:812-789-8883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN221650Medicare ID - Type Unspecified