Organization
RIVER VALLEY MEDICAL CENTER FAMILY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROCK BORDELON (CEO PRESIDENT)
(318) 226-8202
Entity
Organization
Contact information
Practice address
1652 STATE HIGHWAY 22 W, DARDANELLE, AR 72834-2909
(318) 629-5321
(318) 629-5321
Mailing address
504 TEXAS ST STE 200, SHREVEPORT, LA 71101-3526
(318) 629-5321
(318) 226-2805
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/29/2007
Last updated
08/03/2007
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