Wayfarer, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WAYFARER, INC.

Doing business as

Mediclean

Practice address

1416 Antioch Pike Ste 101
Antioch, TN 37013-2766

Phone

(615) 594-3484

NPI assigned

May 27, 2020

Last updated

May 29, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Francisco Espinosa

Title

Ceo

Phone

(615) 594-3484

Specialties & licenses 1

Addresses

Other names 1

• Mediclean Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590710400000",
    "number": "1619590445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 ANTIOCH PIKE STE 101",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370132766",
            "telephone_number": "615-594-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 ANTIOCH PIKE STE 101",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370132766",
            "telephone_number": "615-594-3484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYFARER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A",
        "authorized_official_last_name": "ESPINOSA",
        "authorized_official_first_name": "FRANCISCO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-594-3484"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mediclean",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Antioch, TN
• Providers in Antioch, TN by specialty
• Durable Medical Equipment & Medical Supplies in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.