Healthcare Provider Details

I. General information

NPI: 1669577912
Provider Name (Legal Business Name): WEBSTER HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 11/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 MEDICAL PLZ
EUPORA MS
39744-4018
US

IV. Provider business mailing address

70 MEDICAL PLZ
EUPORA MS
39744-4018
US

V. Phone/Fax

Practice location:
  • Phone: 662-258-9341
  • Fax: 662-258-9291
Mailing address:
  • Phone: 662-258-9341
  • Fax: 662-258-9291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number657
License Number StateMS

VIII. Authorized Official

Name: MR. JOSEPH A REPPERT
Title or Position: CFO
Credential:
Phone: 662-377-3978