Provider Demographics
NPI:1750042032
Name:WINNESHIEK MEDICAL CENTER
Entity Type:Organization
Organization Name:WINNESHIEK MEDICAL CENTER
Other - Org Name:WINNMED LUTHER CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SLESSOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-387-3145
Mailing Address - Street 1:901 MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101-2325
Mailing Address - Country:US
Mailing Address - Phone:563-382-2911
Mailing Address - Fax:563-382-1507
Practice Address - Street 1:700 COLLEGE DRIVE
Practice Address - Street 2:LARSEN BUILDING-LL
Practice Address - City:DECORAH
Practice Address - State:IA
Practice Address - Zip Code:52101-2325
Practice Address - Country:US
Practice Address - Phone:563-387-1045
Practice Address - Fax:563-387-1053
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINNESHIEK MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-07
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0134220Medicaid
IA1134220Medicaid