Provider Demographics
NPI: | 1124026182 |
---|---|
Name: | WAYNE MEMORIAL HOSPITAL |
Entity type: | Organization |
Organization Name: | WAYNE MEMORIAL HOSPITAL |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CHEIF FINANCIAL OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | PATRICIA |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | DUNSINGER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 570-253-8133 |
Mailing Address - Street 1: | 601 PARK ST |
Mailing Address - Street 2: | |
Mailing Address - City: | HONESDALE |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 18431-1445 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 570-253-8100 |
Mailing Address - Fax: | 570-253-7312 |
Practice Address - Street 1: | 601 PARK ST |
Practice Address - Street 2: | |
Practice Address - City: | HONESDALE |
Practice Address - State: | PA |
Practice Address - Zip Code: | 18431-1445 |
Practice Address - Country: | US |
Practice Address - Phone: | 570-253-8100 |
Practice Address - Fax: | 570-253-8425 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2005-07-13 |
Last Update Date: | 2025-04-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 282N00000X | Hospitals | General Acute Care Hospital | ||
No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | Group - Multi-Specialty |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
No | 207VF0040X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Urogynecology and Reconstructive Pelvic Surgery | Group - Multi-Specialty |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | ||
No | 2086S0102X | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | Group - Multi-Specialty |
No | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty | |
No | 251G00000X | Agencies | Hospice Care, Community Based | ||
No | 261QR0200X | Ambulatory Health Care Facilities | Clinic/Center | Radiology | |
No | 261QR0400X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation | |
No | 291U00000X | Laboratories | Clinical Medical Laboratory |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PA | 0697084 | Medicaid | |
PA | 0697084 | Medicaid |