Organization
WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
Active
Other names
WAYMART FAMILY HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FREDERICK JACKSON (EXECUTIVE DIRECTOR)
(570) 253-8450
Entity
Organization
Contact information
Practice address
601 PARK ST, HONESDALE, PA 18431-1445
(570) 251-6676
(570) 251-6668
Mailing address
29 WOODLANDS DR, WAYMART, PA 18472-9366
(570) 251-6676
(570) 251-6668
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
12/10/2008
Last updated
07/12/2010
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