Provider Demographics
NPI:1629199351
Name:STATEWIDE HEALTHCARE SERVICES, INC
Entity Type:Organization
Organization Name:STATEWIDE HEALTHCARE SERVICES, INC
Other - Org Name:OXFORD HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1800-404-3190
Mailing Address - Street 1:1 N STATE ST
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3302
Mailing Address - Country:US
Mailing Address - Phone:800-404-3191
Mailing Address - Fax:312-704-0022
Practice Address - Street 1:3829 I-55 NORTH
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211
Practice Address - Country:US
Practice Address - Phone:601-982-7311
Practice Address - Fax:601-982-7462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health