Healthcare Provider Details

I. General information

NPI: 1114195617
Provider Name (Legal Business Name): WAYNE MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 03/24/2020
Certification Date: 03/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 WAYNE MEMORIAL DR.
GOLDSBORO NC
27534-9494
US

IV. Provider business mailing address

2700 WAYNE MEMORIAL DR.
GOLDSBORO NC
27534-9494
US

V. Phone/Fax

Practice location:
  • Phone: 919-731-6142
  • Fax:
Mailing address:
  • Phone: 919-731-6142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberH0257
License Number StateNC

VIII. Authorized Official

Name: MR. WILLIAM G THOMA III
Title or Position: SR VICE PRESIDENT FINANCE / CFO
Credential:
Phone: 919-731-6143