Provider Demographics
NPI:1437288420
Name:WAYNE COUNTY HEALTH CENTER
Entity Type:Organization
Organization Name:WAYNE COUNTY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RAE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:CRUTCHFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-224-3218
Mailing Address - Street 1:115 HICKORY STREET
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63944-0259
Mailing Address - Country:US
Mailing Address - Phone:573-224-3218
Mailing Address - Fax:573-224-3164
Practice Address - Street 1:115 HICKORY STREET
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MO
Practice Address - Zip Code:63944-0259
Practice Address - Country:US
Practice Address - Phone:573-224-3218
Practice Address - Fax:573-224-3164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty