1881061059 NPI number — WINDROSE HEALTH NETWORK, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881061059 NPI number — WINDROSE HEALTH NETWORK, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WINDROSE HEALTH NETWORK, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881061059
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14 TRAFALGAR SQ
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TRAFALGAR
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46181-9515
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-739-4895
Provider Business Mailing Address Fax Number:
317-878-2355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5550 S EAST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46227-1979
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-534-4660
Provider Business Practice Location Address Fax Number:
317-888-8419
Provider Enumeration Date:
08/24/2015

Additional Information

Authorized Official

Authorized Official Last Name:
ROLLETT
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
317-680-9553

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 151957 . This is a "MEDICARE FQHC" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200127470F , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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