Organization
WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
Active
Other names
Pinnacle Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK JACKSON (EXECUTIVE DIRECTOR)
(570) 253-8450
Entity
Organization
Contact information
Practice address
132 MANLY RD, TAFTON, PA 18464-7829
(570) 226-2151
(570) 226-1861
Mailing address
601 PARK ST, HONESDALE, PA 18431-1445
(570) 253-8226
(570) 253-8228
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
PA
207R00000X
Internal Medicine Physician
—
PA
207V00000X
Obstetrics & Gynecology Physician
—
PA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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