Provider Demographics
NPI:1619959848
Name:WAYNE HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:WAYNE HEALTH SERVICES, INC.
Other - Org Name:WAYNE HEALTH EQUIPMENT AND SERVICES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARRIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:LATZKO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:570-253-6770
Mailing Address - Street 1:600 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-1456
Mailing Address - Country:US
Mailing Address - Phone:570-253-6770
Mailing Address - Fax:570-251-6585
Practice Address - Street 1:600 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-1456
Practice Address - Country:US
Practice Address - Phone:570-253-6770
Practice Address - Fax:570-251-6585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007277580007Medicaid
PA1510801OtherGATEWAY HEALTH PLAN
PA806306OtherFIRST PRIORITY HEALTH
PA814226OtherFIRST PRIORITY HEALTH ORT
PA88701OtherMED PLUS/THREE RIVERS
A937331OtherOXFORD HEALTH
207310OtherBLUE CROSS/BLUE SHIELD
497868OtherFEDERAL BLACK LUNG
606096OtherAETNA
PA30178OtherGEISINGER HEALTH/GOLD
NY01238013Medicaid
PA1445280OtherBC ACCESS ORTHOTIC/PROTH
3Y0296OtherHEALTHNET
1065005OtherW VIRGINIA WORKERS COMP
PA1007277580007Medicaid