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Organization

RICHARDSON MEDICAL CENTER HOMECARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PETER C. NOVEMBER II (EXECUTIVE VICE PRESIDENT)
(337) 233-1307
Entity
Organization

Contact information

Practice address
1612 JULIA ST, RAYVILLE, LA 71269-3504
(318) 728-5397
(318) 728-4067
Mailing address
P.O. BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1027
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1402532
LA
01
190030890Z
BLUE CROSS BLUE SHIELD OF
LA
Enumeration date
06/02/2006
Last updated
11/09/2012
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