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General NPI Number Information
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NPI Number | 1407015134
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Entity Type | Organization
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Legal Business Name | WINSLOW COMMUNITY HEALTH CENTER, INC.
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Dates
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Enumeration Date | 06/06/2008
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Last Update Date | 08/26/2008
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Provider Practice Location Address
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Address Line | 200 N MAIN ST
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City | WINSLOW
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State | IN
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Zip | 47598-5423
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Country | US
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Telephone | 812-789-2529
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Fax | 812-789-2574
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Provider Business Mailing Address
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Address Line | PO BOX 516
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City | WINSLOW
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State | IN
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Zip | 47598-0516
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Country | US
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Telephone | 812-789-2529
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Fax | 812-789-2574
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. THOMAS A VINNEDGE
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Credential |
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Telephone | 812-789-2529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28143885A
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License Number State | IN
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