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Wayne Memorial Community Health Centers

Organization Active NPI Federally Qualified Health Center (FQHC) · Lords Valley, PA

NPI 1184055428 · NPPES record last updated Dec 12, 2013

Key facts

NPI
1184055428
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
Practice address
750 Route 739
Suite D
Lords Valley, PA 18428-6071
Phone
(570) 251-6534
NPI assigned
Dec 12, 2013
Organization subpart
No

Authorized official

Name
Frederick Jackson
Title
Executive Director
Phone
(570) 253-8450

Corporate family (same tax ID) 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

National Provider Directory

Tax ID family
Hamlin Family Health Center (27 organizations share this tax ID)

Locations

750 Route 739
Ste D
Lords Valley, PA 18428
Phone (570) 251-6534

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193200000X MULTI-SPECIALTY GROUP		 1223G0001X
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

750 Route 739
Suite D
Lords Valley, PA 18428-6071

Mailing address

601 Park St
Honesdale, PA 18431-1445

Other names

  • Pike County Behavioral Health and Dental Clinic Doing business as

Other providers in Lords Valley, PA

All providers in Lords Valley, PA · Federally Qualified Health Center (FQHC) in Pennsylvania

Sources for this page

Verify at the official NPI Registry.