Provider Demographics
NPI:1184266520
Name:WINDROSE HEALTH NETWORK, INC.
Entity type:Organization
Organization Name:WINDROSE HEALTH NETWORK, INC.
Other - Org Name:
Other - Org Type:
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 1:911 E MAIN CROSS ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:46124-1501
Mailing Address - Country:US
Mailing Address - Phone:317-680-9901
Mailing Address - Fax:812-526-4900
Practice Address - Street 1:911 E MAIN CROSS ST
Practice Address - Street 2:
Practice Address - City:EDINBURGH
Practice Address - State:IN
Practice Address - Zip Code:46124-1501
Practice Address - Country:US
Practice Address - Phone:317-680-9901
Practice Address - Fax:812-526-4900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-16
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)