MEDICARE: WINN COMMUNITY HEALTH CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1023629425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINN COMMUNITY HEALTH CENTER, INC.

Provider Business Mailing Address
First Line	:	PO BOX 1288
Second Line	:
City	:	WINNFIELD
State	:	LA
Zip	:	71483-1288
Country	:	US
Telephone Number	:	318-209-4510
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 N BOLTON AVE
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71303-4407
Country	:	US
Telephone Number	:	318-648-0375
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	DAVID ADAMS
Credential	:
Telephone Number	:	318-648-0375

Provider Enumeration Date	:	08/11/2020
Last Update Date	:	08/11/2020

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