# ROCKDALE BLACKHAWK LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Richards Memorial Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265648927
- **Authorized official:** SHANA DAVENPORT (SUPERVISOR, INSURANCE CREDENTIALING)
- **Authorized official phone:** (512) 446-4500

## Contact information

- **Practice address:** 1700 BRAZOS AVE, ROCKDALE, TX 76567-2517
- **Practice address phone:** (512) 445-4500
- **Practice address fax:** (512) 446-2063
- **Mailing address:** PO BOX 1010, ROCKDALE, TX 76567-1010
- **Mailing address phone:** (512) 446-4500
- **Mailing address fax:** (512) 446-2063

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 000369 | TX | Yes |

## Other

- **Enumeration date:** 05/16/2007
- **Last updated:** 02/08/2008