1821091059 NPI number — WAYNESBORO HOSPITAL

Table of content: (NPI 1821091059)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821091059 NPI number — WAYNESBORO HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WAYNESBORO HOSPITAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WELLSPAN WAYNESBORO HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821091059
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
785 5TH AVE STE 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHAMBERSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17201-4232
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-263-9555
Provider Business Mailing Address Fax Number:
717-709-6529

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAYNESBORO
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17268-2353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-765-4000
Provider Business Practice Location Address Fax Number:
717-765-3498
Provider Enumeration Date:
05/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BUCZKOWSKI
Authorized Official First Name:
LAURA
Authorized Official Middle Name:
Authorized Official Title or Position:
SR VP AND CFO
Authorized Official Telephone Number:
410-442-3373

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 234301 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000111264 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 235019 . This is a "OPTIMUM CHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 792988 . This is a "MAPSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 25331 . This is a "SENIOR PARTNERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 6491440 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 809534 . This is a "PRIORITY PARTNERS JOHN HO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0171193000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 072768701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02567664 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10368B , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1007424870006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3900138 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010040744 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0413202 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1489 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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