Provider Demographics
NPI:1215105713
Name:WAYNE MEMORIAL HOSPITAL INC
Entity type:Organization
Organization Name:WAYNE MEMORIAL HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:W
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-731-6142
Mailing Address - Street 1:2700 WAYNE MEMORIAL DR.
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-9459
Mailing Address - Country:US
Mailing Address - Phone:919-731-6142
Mailing Address - Fax:
Practice Address - Street 1:2700 WAYNE MEMORIAL DR.
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-9459
Practice Address - Country:US
Practice Address - Phone:919-731-6142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0257273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3400010SMedicaid
NC34S010Medicare Oscar/Certification