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Organization
ROCKDALE BLACKHAWK LLC
Active
Organization
ROCKDALE BLACKHAWK LLC
Active
Other names
Richards Memorial Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
SHANA DAVENPORT (SUPERVISOR, INSURANCE CREDENTIALING)
(512) 446-4500
Entity
Organization
Contact information
Practice address
1700 BRAZOS AVE, ROCKDALE, TX 76567-2517
(512) 445-4500
(512) 446-2063
Mailing address
PO BOX 1010, ROCKDALE, TX 76567-1010
(512) 446-4500
(512) 446-2063
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
000369
TX
Other
Enumeration date
05/16/2007
Last updated
02/08/2008
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