| NPI | 1407091077 |
|---|---|
| Doing Business As | WAYMART FAMILY HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | FREDERICK JACKSON Executive Director 570-253-8450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2010-07-12 |