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CHC08760-18 WAYNE MEMORIAL COMMUNITY HEALTH CENTERS (Active)
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Main Details
Name
WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
Subdivision Name
Sterling Pediatric Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027964
340B ID
CHC08760-18
Grant Number
H80CS08760
Additional Details
Current Program Status
Active
Registration Date
10/1/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/3/2019
Last Recertification Date
2/24/2025
Contacts
Authorizing Official
Wayne Memorial Community Health Centers
Robert J. Fortuner II, Finance Director
(570) 253-8337
Primary Contact
Wayne Memorial Community Health Centers
Emily Wood, Senior Accountant
(570) 251-6562
Addresses
Street Address
62 Industrial Park Rd
Lake Ariel, PA 18436-5606
Billing Address
Wayne Memorial Community Health Centers
601 Park Street
Honesdale, PA 18431
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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