Organization · Type 2 NPI
Wayne Memorial Community Health Centers
Federally Qualified Health Center (FQHC) · Lake Como, PA
NPI number
1669654596
Active
Practice location
412 Como Road
Lake Como, PA 18437-0000
Fax (570) 798-2636
Mailing address
601 Park St
Honesdale, PA 18431-1445
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine Physician | 207Q00000X | OS011217 (PA) |
| Internal Medicine Physician | 207R00000X | MD428487 (PA) |
| Federally Qualified Health Center (FQHC) Primary | 261QF0400X | None listed |
Federally Qualified Health Center (FQHC): Definition to come...
Another provider at this address
About NPI 1669654596
Wayne Memorial Community Health Centers's National Provider Identifier is 1669654596, issued on Dec 3, 2007. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Lake Como, PA. The record was last updated on Apr 7, 2015.