Organization
WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
Active
Organization
WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
Active
Other names
Honesdale Pulmonary
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK JACKSON (EXECUTIVE DIRECTOR)
(570) 253-8450
Entity
Organization
Contact information
Practice address
600 MAPLE AVE, SUITE 4, HONESDALE, PA 18431-1459
(570) 253-8643
Mailing address
601 PARK ST, HONESDALE, PA 18431-1445
(570) 253-8643
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
05/16/2016
Last updated
05/16/2016
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