Healthcare Provider Details
I. General information
NPI: 1295789352
Provider Name (Legal Business Name): WINONA HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2006
Last Update Date: 05/18/2021
Certification Date: 05/18/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
855 MANKATO AVE
WINONA MN
55987-5377
US
IV. Provider business mailing address
855 MANKATO AVE PO BOX 5600
WINONA MN
55987-5377
US
V. Phone/Fax
- Phone: 507-454-3650
- Fax: 507-457-4413
- Phone: 507-454-3650
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | MN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | 331049 |
| License Number State | MN |
VIII. Authorized Official
Name: MS.
RACHELLE
SCHULTZ
Title or Position: CEO
Credential:
Phone: 507-457-4300