Provider Demographics
NPI:1821091059
Name:WAYNESBORO HOSPITAL
Entity type:Organization
Organization Name:WAYNESBORO HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR VP AND CFO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCZKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-442-3373
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:501 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-2353
Practice Address - Country:US
Practice Address - Phone:717-765-4000
Practice Address - Fax:717-765-3498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X
PA234301282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010040744Medicaid
WV0171193000Medicaid
PA25331OtherSENIOR PARTNERS
NC3900138Medicaid
PA1489OtherHIGHMARK BLUE SHIELD
MD235019OtherOPTIMUM CHOICE
NY02567664Medicaid
SC10368BMedicaid
PA000000111264Medicaid
TX072768701Medicaid
PA6491440OtherAETNA
MD792988OtherMAPSI
MT0413202Medicaid
PA1007424870006Medicaid
MD809534OtherPRIORITY PARTNERS JOHN HO
PA1007424870006Medicaid
WV0171193000Medicaid
MD792988OtherMAPSI
MD235019OtherOPTIMUM CHOICE
PA39U138Medicare ID - Type Unspecified