Provider Demographics
NPI:1871650895
Name:MRH DBA WMC
Entity Type:Organization
Organization Name:MRH DBA WMC
Other - Org Name:WAYNE CARE NURSING HOME
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRINKLEY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:931-405-4212
Mailing Address - Street 1:103 JV MANGUBAT DRIVE
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:38485
Mailing Address - Country:US
Mailing Address - Phone:931-722-3641
Mailing Address - Fax:931-722-7215
Practice Address - Street 1:505 SOUTH HIGH STREET
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:TN
Practice Address - Zip Code:38485
Practice Address - Country:US
Practice Address - Phone:931-722-5832
Practice Address - Fax:931-722-6522
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAURY REGIONAL HOSPITAL DBA WAYNE MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-02
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN277313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7440515Medicaid