Basic Information
Provider Information
NPI: 1881699247
EntityType: 2
ReplacementNPI:  
OrganizationName: WAYNESBORO HOSPITAL
LastName:  
FirstName:  
MiddleName:  
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Credential:  
OtherOrganizationName: WAYNESBORO HOSPITAL EMERGENCY DEPT
OtherOrganizationType: 5
OtherLastName:  
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Mailing Information
Address1: 785 5TH AVE STE 3
Address2:  
City: CHAMBERSBURG
State: PA
PostalCode: 172014232
CountryCode: US
TelephoneNumber: 7172639555
FaxNumber: 7177096529
Practice Location
Address1: 501 EAST MAIN STREET
Address2:  
City: WAYNESBORO
State: PA
PostalCode: 17268
CountryCode: US
TelephoneNumber: 7177653400
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/14/2005
LastUpdateDate: 09/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: DUBROW
AuthorizedOfficialFirstName: MELISSA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: VP & PRESIDENT
AuthorizedOfficialTelephone: 6103724957
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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NPICertificationDate: 09/28/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X234301PAY193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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