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General NPI Number Information
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NPI Number | 1023191467
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Entity Type | Organization
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Legal Business Name | WINDHAM COMMUNITY MEMORIAL HOSPITAL, INC.
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Dates
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Enumeration Date | 10/21/2006
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 112 MANSFIELD AVE
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City | WILLIMANTIC
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State | CT
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Zip | 06226-2045
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Country | US
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Telephone | 860-456-6752
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Fax | 203-265-4557
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Provider Business Mailing Address
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Address Line | 112 MANSFIELD AVE
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City | WILLIMANTIC
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State | CT
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Zip | 06226-2045
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Country | US
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Telephone | 860-425-8755
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Fax | 860-885-6492
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Authorized Official
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Title or Position | VP OF FINANCE
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Name | MS. JANICE MACKIE
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Credential |
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Telephone | 860-425-8755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 0061
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number | 0061
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 0061
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License Number State | CT
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Taxonomy #5
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 0061
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License Number State | CT
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Taxonomy #6
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 0061
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License Number State | CT
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Taxonomy #7
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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