Organization
WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
Active
Other names
WOMENS HEALTH CARE-LORDS VALLEY
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK JACKSON (EXECUTIVE DIRECTOR)
(570) 253-8450
Entity
Organization
Contact information
Practice address
750 ROUTE 739, SUITE C, HAWLEY, PA 18428-6071
(570) 775-8838
Mailing address
110 PARK ST, HONESDALE, PA 18431-2023
(570) 253-3005
(570) 253-0810
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
12/17/2008
Last updated
12/17/2008
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