MEDICARE: WAYNE MEMORIAL HOSPITAL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital	H0257	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750353462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAYNE MEMORIAL HOSPITAL INC

Provider Business Mailing Address
First Line	:	2700 WAYNE MEMORIAL DR
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-9494
Country	:	US
Telephone Number	:	919-731-6142
Fax Number	:	919-731-6966

Provider Business Practice Location Address
First Line	:	2700 WAYNE MEMORIAL DR
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-9459
Country	:	US
Telephone Number	:	919-731-6142
Fax Number	:	919-731-6966

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	DR. JESSIE L TUCKER III
Credential	:
Telephone Number	:	919-731-6142

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	03/10/2026

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