Provider Demographics
NPI:1881061059
Name:WINDROSE HEALTH NETWORK, INC.
Entity type:Organization
Organization Name:WINDROSE HEALTH NETWORK, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-680-9553
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 1:5550 S EAST ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-1979
Practice Address - Country:US
Practice Address - Phone:317-534-4660
Practice Address - Fax:317-888-8419
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINDROSE HEALTH NETWORK, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-24
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN151957OtherMEDICARE FQHC
IN200127470FMedicaid