Provider Demographics
NPI:1689701120
Name:WAYNE HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:WAYNE HEALTH SERVICES, INC
Other - Org Name:DBA/ WAYNE HEALTH PHARMACY AND MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:PIOTROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:570-253-8162
Mailing Address - Street 1:600 MAPLE AVE
Mailing Address - Street 2:SUITE 11
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431
Mailing Address - Country:US
Mailing Address - Phone:570-253-8162
Mailing Address - Fax:570-257-6570
Practice Address - Street 1:600 MAPLE AVE
Practice Address - Street 2:SUITE 11
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431
Practice Address - Country:US
Practice Address - Phone:570-253-8162
Practice Address - Fax:570-257-6570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP415274L333600000X
PA333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007383590017Medicaid