Organization
WINDHAM COMMUNITY MEMORIAL HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANICE MACKIE (VP OF FINANCE)
(860) 425-8755
Entity
Organization
Contact information
Practice address
112 MANSFIELD AVE, WILLIMANTIC, CT 06226-2045
(860) 456-6752
(203) 265-4557
Mailing address
112 MANSFIELD AVE, WILLIMANTIC, CT 06226-2045
(860) 425-8755
(860) 885-6492
Taxonomy
Speciality
Code
Description
License number
State
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
Primary
—
—
363LN0000X
Neonatal Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014138
AETNA
CO
05
—
004025110
—
CT
05
—
004041828
—
CT
01
—
022
BLUE CROSS
CT
01
—
0465969015
CIGNA
CT
01
—
H01661
OXFORD
CT
01
—
H055902
HEALTHNET
CT
01
—
TRICARE
35175
CT
Enumeration date
10/21/2006
Last updated
04/12/2023
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