Organization
RIVERSIDE MEDICAL CENTER
Active
Other names
Riverside Pediatrics and Internal Medicine Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY K MCGRAW (BUSINESS OFFICE DIRECTOR)
(985) 795-4168
Entity
Organization
Contact information
Practice address
711 RIVERSIDE DR, FRANKLINTON, LA 70438-3633
(985) 795-4294
(985) 839-0948
Mailing address
1900 MAIN ST, FRANKLINTON, LA 70438-3688
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2432630
—
LA
Enumeration date
11/18/2015
Last updated
09/19/2022
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