Provider Demographics
NPI:1760447254
Name:STEWART - WEBSTER HOSPITAL, INC.
Entity Type:Organization
Organization Name:STEWART - WEBSTER HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RANSOM
Authorized Official - Middle Name:
Authorized Official - Last Name:STIGLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-887-3366
Mailing Address - Street 1:580 ALSTON ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31825-1406
Mailing Address - Country:US
Mailing Address - Phone:229-887-3366
Mailing Address - Fax:229-887-3400
Practice Address - Street 1:580 ALSTON ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:GA
Practice Address - Zip Code:31825-1406
Practice Address - Country:US
Practice Address - Phone:229-887-3366
Practice Address - Fax:229-887-3400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA128-419282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAHOSP168OtherMEDICARE PART B
GA00001845AMedicaid
111322Medicare Oscar/Certification