Organization
HEALTH PARADIGM OF RUSTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISA M VANDENBERG (ADMINISTRATOR)
(318) 251-2322
Entity
Organization
Contact information
Practice address
615 S TRENTON ST, RUSTON, LA 71270-5040
(318) 251-2322
(315) 251-0710
Mailing address
615 S TRENTON ST, RUSTON, LA 71270-5040
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1191485
—
LA
Enumeration date
05/29/2007
Last updated
08/22/2020
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