Organization
RIVERPARK COMMUNITY CATH LAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT WHITTEMORE (CHIEF FINACIAL OFFICER)
(601) 445-6203
Entity
Organization
Contact information
Practice address
107 FRONT ST, VIDALIA, LA 71373-2836
(601) 445-1703
(601) 445-6726
Mailing address
PO BOX 35, 107 FRONT ST., VIDALIA, LA 71373-0035
(601) 445-1703
(601) 445-6726
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/09/2006
Last updated
08/22/2020
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