Provider Demographics
NPI:1598760829
Name:ST. JOSEPH'S WAYNE HOSPITAL
Entity Type:Organization
Organization Name:ST. JOSEPH'S WAYNE HOSPITAL
Other - Org Name:WAYNE GENERAL HOSPITAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-754-2016
Mailing Address - Street 1:224 HAMBURG TPKE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2111
Mailing Address - Country:US
Mailing Address - Phone:973-956-3500
Mailing Address - Fax:973-389-4044
Practice Address - Street 1:224 HAMBURG TPKE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2111
Practice Address - Country:US
Practice Address - Phone:973-956-3500
Practice Address - Fax:973-389-4044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-14
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ11603282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4141407Medicaid
NJ4141407Medicaid