Provider Demographics
NPI:1144521089
Name:WINONA HEALTH SERVICES
Entity type:Organization
Organization Name:WINONA HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEISING SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:507-454-3650
Mailing Address - Street 1:859 MANKATO AVE
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-6435
Mailing Address - Country:US
Mailing Address - Phone:507-457-4156
Mailing Address - Fax:507-457-8598
Practice Address - Street 1:859 MANKATO AVE
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-6435
Practice Address - Country:US
Practice Address - Phone:507-457-7688
Practice Address - Fax:507-457-8598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-09
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X
MN2636033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1144521089Medicaid
2127620OtherPK
MN0333900002Medicare NSC