WAYNE MEMORIAL COMMUNITY HEALTH CENTERS (NPI# 1902159619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902159619 |
| Entity Type | Organization |
| Organization Name | WAYNE MEMORIAL COMMUNITY HEALTH CENTERS |
| Other Organization Name | CARBONDALE FAMILY HEALTH CENTER |
| Practice Address |
141 Salem Ave Ste 302 Carbondale PA 18407-2574 |
| Mailing Address |
601 Park St Honesdale PA 18431-1445 |
| Practice Telephone | 5702822031 |
| Practice Fax Number | 5702822534 |
| Mailing Telephone | 5702516641 |
| Mailing Fax Number | 5702538228 |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2020-03-10 |
| 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 | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Carbondale Family Health Center | Doing Business As Name - 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 |
| 1558882720 | Wayne Memorial Community Health Centers | Family Medicine | 600 Maple Ave Ste 15, Honesdale, PA 18431-1460 | 2017-06-28 |
| 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 |
| 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 |
141 SALEM AVE STE 302 |
| City | CARBONDALE |
| State | PA |
| Zip Code | 18407-2574 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669445755 | Alexander J Pinsky | Pediatrics | 141 Salem Ave Ste 302, Carbondale, PA 18407-2500 | 2006-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235761784 | Ashley Ettinger | Counselor | 38 North Scott Road, Carbondale, PA 18407 | 2020-02-12 |
| 1639723109 | Dana Marie Marmo | Counselor | 141 Salem Ave Suite 104, Carbondale, PA 18407 | 2019-08-01 |
| 1831694991 | William Vitzakovitch | Physical Therapist | 504 1/2 Scranton Carbondale Hwy, Mayfield, PA 18407 | 2018-03-29 |
| 1205345014 | The Young Men's Christian Association of Carbondale | Health Educator | 82 N Main Street, Carbondale, PA 18407 | 2017-09-25 |
| 1942722327 | Jamee Ruddy | Early Intervention Provider Agency | 77 Jefferson Street, Simpson, PA 18407 | 2017-07-07 |
| 1417181082 | Paul Erik Larson | Specialist/Technologist | 101 Brooklyn Street/business Route 6, Carbondale, PA 18407 | 2009-05-11 |
| 1316061708 | Christine Marie Roberts | Occupational Therapist | Carbondale Nursing Home, 10 Hart Place, Carbondale, PA 18407 | 2007-03-19 |
| 1407944036 | Brian John Piatak | Chiropractor | 30 N Scott Street, Carbondale, PA 18407 | 2006-10-10 |
| 1427556133 | Brianna Marie Bennici | Occupational Therapy Assistant | 45 N Scott St, Carbondale, PA 18407 | 2018-01-28 |
| 1144632332 | Dannielle S Hafler | Social Worker | 32 N Main St, Carbondale, PA 18407 | 2014-05-22 |
| Find all providers in zip 18407 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1699232512 | Shawnee Health Service and Development Corp | Clinic/Center | 801 S Lewis Ln Rm 153, Carbondale, IL 62901-3408 | 2019-02-27 |
| 1487111639 | Shawnee Health Service and Development Corp | Clinic/Center | 121 N Parrish Ln Rm 123, Carbondale, IL 62901-2024 | 2019-02-25 |
| 1841757242 | Shawnee Health Service and Development Corp | Clinic/Center | 1150 E Grand Ave Rm 127, Carbondale, IL 62901-3422 | 2019-02-22 |
| 1326079245 | Shawnee Health Service and Development Corp | Clinic/Center | 1301 E Walnut St Rm J120, Carbondale, IL 62901-5004 | 2006-07-06 |
| 1316939929 | Community Health & Emergency Services, Inc. | Clinic/Center | 1340 Cedar Ct, Carbondale, IL 62901-5336 | 2005-08-19 |
| 1073572350 | Community Health & Emergency Services, Inc | Clinic/Center | 1250 Cedar Ct, Carbondale, IL 62901-5334 | 2006-03-23 |
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|---|---|---|---|---|
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| 1538781166 | Hyndman Area Health Center, Inc. | Clinic/Center | 214 College Park Plz Ste 203, Johnstown, PA 15904-2833 | 2020-05-18 |
| 1588285076 | Community Health and Dental Care, Inc | Clinic/Center | 1315 Route 100 North, Barto, PA 19504-8724 | 2020-05-06 |
| 1053946079 | Neighborhood Health Centers of The Lehigh Valley | Clinic/Center | 635 E Broad St, Bethlehem, PA 18018-6332 | 2020-03-10 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 18407 |
Please comment or provide details below to improve the information on WAYNE MEMORIAL COMMUNITY HEALTH CENTERS.
| 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.