Provider Demographics
NPI:1255574331
Name:WAKE HEALTH SERVICES, INC
Entity type:Organization
Organization Name:WAKE HEALTH SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORLANDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-250-2939
Mailing Address - Street 1:2620 NEW BERN AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1821
Mailing Address - Country:US
Mailing Address - Phone:919-250-2944
Mailing Address - Fax:919-250-2949
Practice Address - Street 1:1012 OBERLIN RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1135
Practice Address - Country:US
Practice Address - Phone:919-833-3111
Practice Address - Fax:919-250-2949
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WAKE HEALTH SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)