| Windrose Health Network - Countyline | |
|
8921 Southpointe Dr Suite A1 Indianapolis IN 46227-1084 | |
| (317) 884-7820 | |
| (317) 888-8851 |
| Full Name | Windrose Health Network - Countyline |
|---|---|
| Speciality | Clinic/Center |
| Location | 8921 Southpointe Dr, Indianapolis, Indiana |
| Authorized Official Name and Position | Scott K Rollett (CFO / COO) |
| Authorized Official Contact | 3177394895 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Windrose Health Network - Countyline 14 Trafalgar Sq Trafalgar IN 46181-9515 Ph: (317) 739-4895 | Windrose Health Network - Countyline 8921 Southpointe Dr Suite A1 Indianapolis IN 46227-1084 Ph: (317) 884-7820 |
| NPI Number | 1154699346 |
|---|---|
| Provider Enumeration Date | 12/02/2011 |
| Last Update Date | 10/09/2019 |
| Medicare PECOS PAC ID | 8426965039 |
|---|---|
| Medicare Enrollment ID | O20120201000928 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154699346 | NPI | - | NPPES |
| 200127470E | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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