Organization
LITTLE RIVER MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY P MADISON CEO (CEO)
(512) 446-4500
Entity
Organization
Contact information
Practice address
1904 RAILROAD ST, GEORGETOWN, TX 78626-7718
(512) 863-4563
(512) 869-5899
Mailing address
1904 RAILROAD ST, GEORGETOWN, TX 78626-7718
(512) 863-4563
(512) 869-5899
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/13/2014
Last updated
10/13/2014
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