Provider Demographics
NPI:1619590445
Name:WAYFARER, INC.
Entity Type:Organization
Organization Name:WAYFARER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-594-3484
Mailing Address - Street 1:1416 ANTIOCH PIKE STE 101
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-2766
Mailing Address - Country:US
Mailing Address - Phone:615-594-3484
Mailing Address - Fax:
Practice Address - Street 1:1416 ANTIOCH PIKE STE 101
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-2766
Practice Address - Country:US
Practice Address - Phone:615-594-3484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-27
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies