Healthcare Provider Details

I. General information

NPI: 1962826362
Provider Name (Legal Business Name): WAYNE COMMUNITY HEALTH CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 02/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 N CENTER ST
ESCALANTE UT
84726-0276
US

IV. Provider business mailing address

PO BOX 303
BICKNELL UT
84715-0303
US

V. Phone/Fax

Practice location:
  • Phone: 435-826-4374
  • Fax:
Mailing address:
  • Phone: 435-425-3744
  • Fax: 435-425-3785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: REGINA FLANAGAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 435-425-1102