# WINDHAM COMMUNITY MEMORIAL HOSPITAL, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023191467
- **Authorized official:** MS. JANICE MACKIE (VP OF FINANCE)
- **Authorized official phone:** (860) 425-8755

## Contact information

- **Practice address:** 112 MANSFIELD AVE, WILLIMANTIC, CT 06226-2045
- **Practice address phone:** (860) 456-6752
- **Practice address fax:** (203) 265-4557
- **Mailing address:** 112 MANSFIELD AVE, WILLIMANTIC, CT 06226-2045
- **Mailing address phone:** (860) 425-8755
- **Mailing address fax:** (860) 885-6492

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208M00000X | Hospitalist Physician | — | NULL | — |
| 208M00000X | Hospitalist Physician | — | — | — |
| 261QC1500X | Community Health Clinic/Center | 0061 | CT | — |
| 261QE0002X | Emergency Care Clinic/Center | 0061 | CT | — |
| 261QP2000X | Physical Therapy Clinic/Center | 0061 | CT | — |
| 261QR0200X | Radiology Clinic/Center | 0061 | CT | — |
| 282N00000X | General Acute Care Hospital | 0061 | CT | — |
| 282N00000X | General Acute Care Hospital | — | NULL | Yes |
| 363LN0000X | Neonatal Nurse Practitioner | — | NULL | — |
| 363LN0000X | Neonatal Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/21/2006
- **Last updated:** 04/12/2023