=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184621161
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WAYNE HOSPITAL COMPANY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/05/2005
-----------------------------------------------------
Last Update Date | 08/20/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 835 SWEITZER ST
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45331-1007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-548-1141
-----------------------------------------------------
Fax | 937-547-5784
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 835 SWEITZER ST
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45331-1007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-548-1141
-----------------------------------------------------
Fax | 937-547-5784
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | MS. NICKI GILLESPIE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 937-569-6758
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282NC0060X
-----------------------------------------------------
Taxonomy Name | Critical Access Hospital
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------