Healthcare Provider Details

I. General information

NPI: 1386610145
Provider Name (Legal Business Name): WAYNE COUNTY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 HICKORY ST
GREENVILLE MO
63944-0259
US

IV. Provider business mailing address

115 HICKORY ST PO BOX 259
GREENVILLE MO
63944-0259
US

V. Phone/Fax

Practice location:
  • Phone: 573-224-3218
  • Fax: 573-224-3164
Mailing address:
  • Phone: 573-224-3218
  • Fax: 573-224-3164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. RAE J CRUTCHFIELD
Title or Position: ADMINISTRATOR
Credential:
Phone: 573-224-3218