Organization
RIVERSIDE MEDICAL CENTER
Active
Other names
Riverside Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY K MCGRAW (BUSINESS OFFICE DIRECTOR)
(985) 795-4168
Entity
Organization
Contact information
Practice address
1900 MAIN ST, FRANKLINTON, LA 70438-3688
(985) 839-4431
(985) 839-0319
Mailing address
1900 MAIN ST, FRANKLINTON, LA 70438-3688
(985) 839-4431
(985) 839-0319
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04798
BLUE CROSS PHY
LA
05
—
1084646
—
LA
01
—
22656
BLUE CROSS PHYSICIAN
LA
01
—
57311
MEDICARE PROFESSIONAL NUMBER
LA
Enumeration date
12/18/2006
Last updated
09/19/2022
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