| Organization Name: | WAYNE MEDICAL CENTER, L.L.C. |
| NPI Number: | 1114901527 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID ANDREW GAYLE (MEMBER) |
| Mailing Address: | Rr 4 Box 4515 Piedmont |
| State: | MO US |
| Postal Code: | 639579417 |
| Phone Number: | 5732234233 |
| Fax Number: | 5732232136 |
| NPI Enumeration Date: | 11/30/2005 |
| NPI Last Update Date: | 03/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |