- Enrollment id
- O20111119000025
- Enrollment state
- IA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1225186638
- Multiple npi flag
- N
- Ccn
- 161553
- Associate id
- 4688582935
- Organization name
- WINNESHIEK MEDICAL CENTER
- Doing business as name
- WINNMED HOSPICE
- Organization type structure
- OTHER
- Organization other type text
- NON-PROFIT
- Proprietary nonprofit
- N
- Address line 1
- 901 MONTGOMERY ST
- Address line 2
- STE D
- City
- DECORAH
- State
- IA
- Zip code
- 521012325