Organization
WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
Active
Other names
Highland Physicians 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
1839 FAIR AVE, HONESDALE, PA 18431-2121
(570) 251-6500
Mailing address
601 PARK ST, HONESDALE, PA 18431-1445
(570) 251-6641
(570) 253-8228
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/02/2015
Last updated
10/08/2015
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