WAYNE MEMORIAL COMMUNITY HEALTH CENTERS (NPI# 1558882720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558882720 |
| Entity Type | Organization |
| Organization Name | WAYNE MEMORIAL COMMUNITY HEALTH CENTERS |
| Other Organization Name | HONESDALE BEHAVORIAL HEALTH |
| Practice Address |
600 Maple Ave Ste 15 Honesdale PA 18431-1460 |
| Mailing Address |
601 Park St Honesdale PA 18431-1445 |
| Practice Telephone | 5702538219 |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2020-09-14 |
| Authorized Official Name | FREDERICK JACKSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5702538450 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Gutherz Family Health Center | Doing Business As Name - Organization |
| Honesdale Behavorial Health | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134771934 | Wayne Memorial Community Health Centers | Clinic/Center | Waymart Pediatric Center, 27b Woodlands Dr, Waymart, PA 18472-9366 | 2019-07-11 |
| 1174974232 | Wayne Memorial Community Health Centers | Obstetrics & Gynecology | 44 N Scott St, Carbondale, PA 18407-2059 | 2016-06-29 |
| 1376950592 | Wayne Memorial Community Health Centers | Social Worker | 600 Maple Ave Ste 6, Honesdale, PA 18431-1436 | 2014-07-21 |
| 1336416619 | Wayne Memorial Community Health Centers | Pediatrics | 152 Brooklyn St, Carbondale, PA 18407-2208 | 2011-11-30 |
| 1780820068 | Wayne Memorial Community Health Centers | Internal Medicine | 543 Easton Tpke, Suite 105, Lake Ariel, PA 18436-4798 | 2008-12-17 |
| 1346854270 | Wayne Memorial Community Health Centers | Emergency Medicine | 273 Grandview Ave, Honesdale, PA 18431-1163 | 2020-09-08 |
| 1194377341 | Wayne Memorial Community Health Centers | Pediatrics | 62 Industrial Park Rd, Lake Ariel, PA 18436-5606 | 2019-07-09 |
| 1932751187 | Wayne Memorial Community Health Centers | Pediatrics | 1837 Fair Ave, Honesdale, PA 18431-2121 | 2019-07-09 |
| 1073960563 | Wayne Memorial Community Health Centers | Psychiatry & Neurology | 600 Maple Ave, Suite 1, Honesdale, PA 18431-1459 | 2016-05-16 |
| 1336596824 | Wayne Memorial Community Health Centers | Internal Medicine | 600 Maple Ave, Suite 1, Honesdale, PA 18431-1459 | 2016-05-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WAYNE MEMORIAL COMMUNITY HEALTH CENTERS | 601 Park Street, Honesdale, PA 18431-1445 |
| Street Address |
600 MAPLE AVE STE 15 |
| City | HONESDALE |
| State | PA |
| Zip Code | 18431-1460 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093287526 | Timothy Gladson | Counselor | 600 Maple Ave Ste 15, Honesdale, PA 18431-1460 | 2018-12-21 |
| 1407353717 | Jamie Sullivan | Nurse Practitioner | 600 Maple Ave Ste 15, Honesdale, PA 18431-1460 | 2018-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487828927 | Sarah Catherine Eibach | Social Worker | 190 Delaware Street, Honesdale, PA 18431 | 2008-04-16 |
| 1437369220 | Michael C Rogers | Dentist | 3373 Lake Ariel Highway, Honesdale, PA 18431 | 2007-05-23 |
| 1053531079 | Matthew James Downey | Internal Medicine | 1860 Fair Avenue, Suite A, Honesdale, PA 18431 | 2007-05-01 |
| 1114049335 | Philip C. Gutherz, Md | Internal Medicine | 700 Maple Avenue, 2nd Floor, Honesdale, PA 18431 | 2007-04-06 |
| 1790806818 | Krina Ennis Pratt | Physical Therapist | Ellen Memorial Health Care Center, 23 Ellen Memorial Lane, Honesdale, PA 18431 | 2007-04-03 |
| 1255465977 | Leonard Weiss | Optometrist | 928 Church St, Honesdale, PA 18431 | 2007-03-15 |
| 1023143724 | Rise Beth Bill | Social Worker | 602 Church Street, Honesdale Wellness Ctr, Honesdale, PA 18431 | 2007-02-22 |
| 1790842375 | Lawrence G Caruth Dmd Assoc | Dentist | 3025 Lake Ariel Hwy, Honesdale, PA 18431 | 2007-01-02 |
| 1225194657 | David Michael Boldish | Dentist | 1325 North Main Street, Honesdale, PA 18431 | 2006-12-29 |
| 1497813562 | George J Gustainis | Family Medicine | 3196 Lake Ariel Hwy, Honesdale, PA 18431 | 2006-12-04 |
| Find all providers in zip 18431 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740490473 | Wayne Memorial Community Health Centers | Clinic/Center | 601 Park St, Honesdale, PA 18431-1445 | 2007-05-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.