Provider Demographics
NPI:1124490784
Name:WAY STATION, INC.
Entity type:Organization
Organization Name:WAY STATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:GUY
Authorized Official - Last Name:ELCHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-662-0099
Mailing Address - Street 1:PO BOX 3826
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21705-3826
Mailing Address - Country:US
Mailing Address - Phone:301-662-0099
Mailing Address - Fax:301-695-2716
Practice Address - Street 1:328 N POTOMAC ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-3820
Practice Address - Country:US
Practice Address - Phone:301-733-6063
Practice Address - Fax:301-733-6220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-22
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD927LMedicare PIN