Healthcare Provider Details
I. General information
NPI: 1477888055
Provider Name (Legal Business Name): WINDHAM COMMUNITY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/15/2009
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
112 MANSFIELD AVE
WILLIMANTIC CT
06226-2045
US
IV. Provider business mailing address
112 MANSFIELD AVE
WILLIMANTIC CT
06226-2045
US
V. Phone/Fax
- Phone: 203-284-1340
- Fax: 203-265-4557
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 341600000X |
| Taxonomy | Ambulance |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | |
| License Number State | CT |
VIII. Authorized Official
Name: MR.
JAMES
N
PAPADAKOS
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 860-456-6848