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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