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NPI Code Detail

MEDICARE: WAVERLEY HEALTH CARE CONSULTANTS, INC.

MEDICARE: WAVERLEY HEALTH CARE CONSULTANTS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1335E00000XProsthetic/Orthotic Supplier0618408MS
2332B00000XDurable Medical Equipment & Medical Supplies0618408MS
3332BP3500XParenteral & Enteral Nutrition Supplies (DME)0618408MS

General Provider Information

NPI Number : 1164472866
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAVERLEY HEALTH CARE CONSULTANTS, INC.
Provider Business Mailing Address
First Line : PO BOX 12000
Second Line :
City : JACKSON
State : MS
Zip : 39236-2000
Country : US
Telephone Number : 601-956-1576
Fax Number :
Provider Business Practice Location Address
First Line : 460 BRIARWOOD DR
Second Line : SUITE 410
City : JACKSON
State : MS
Zip : 39206-3051
Country : US
Telephone Number : 601-956-1576
Fax Number :
Authorized Official
Title or Position : SECRETARY / TREASURER
Name : MR. CHANCEY DUNBAR
Credential : CPA
Telephone Number : 601-956-1576
Provider Enumeration Date : 05/11/2006
Last Update Date : 03/11/2008

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Directions to “WAVERLEY HEALTH CARE CONSULTANTS, INC. ” Practice Location

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