Provider Demographics
NPI:1992921498
Name:WEBSTER HEALTHCARE, INC.
Entity type:Organization
Organization Name:WEBSTER HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEDIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-377-5148
Mailing Address - Street 1:614 WESTON ST
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-3660
Mailing Address - Country:US
Mailing Address - Phone:318-377-5148
Mailing Address - Fax:318-377-2973
Practice Address - Street 1:614 WESTON ST
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3660
Practice Address - Country:US
Practice Address - Phone:318-377-5148
Practice Address - Fax:318-377-2973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0269350001332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1938050Medicaid
LA0269350001Medicare NSC