Organization
WINDHAM COMMUNITY MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANICE MACKIE (CONTROLLER)
(860) 456-6844
Entity
Organization
Contact information
Practice address
123 QUARRY ST, WILLIMANTIC, CT 06226-1247
(860) 465-2620
(860) 465-2638
Mailing address
112 MANSFIELD AVE, WILLIMANTIC, CT 06226-2041
(860) 456-6844
(860) 456-6718
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
96MSBC070CT01
BCFP SCHOOL BASED CLINIC
CT
01
—
OR2915
HEALTH NET SCHOOL BASED C
CT
Enumeration date
05/16/2007
Last updated
08/22/2020
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