Organization
WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
Active
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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