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General NPI Number Information
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NPI Number | 1922168608
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Entity Type | Organization
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Legal Business Name | WAYNE HEALTH CARE
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 06/24/2014
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Provider Practice Location Address
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Address Line | 1200 DRIVING PARK AVE
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City | NEWARK
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State | NY
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Zip | 14513-1057
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Country | US
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Telephone | 315-332-2204
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Fax | 315-332-2428
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Provider Business Mailing Address
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Address Line | PO BOX 111
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City | NEWARK
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State | NY
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Zip | 14513-0111
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Country | US
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Telephone | 315-332-2204
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Fax | 315-332-2428
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Authorized Official
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Title or Position | SVP-FINANCE
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Name | PAULA TINCH
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Credential |
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Telephone | 585-922-1223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 012673
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License Number State | NY
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