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River Park Asc Llc
Ambulatory Surgical Clinic/Center in Vidalia, Louisiana
NPI 1144216847

River Park Asc Llc is an Ambulatory Surgical Clinic/Center based in Vidalia, LA and is specialized in Ambulatory Surgical. River Park Asc Llc practices in Vidalia, LA. The NPI Number for River Park Asc Llc is 1144216847 and holds a License No. 128 (Louisiana).

The current practice location address for River Park Asc Llc is 107 Front St, Vidalia, LA and can be reached out via phone at 318-336-2218.

Location: 107 Front St, Vidalia, LA, 71373-2836
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1144216847
Provider Name
River Park Asc Llc
Credential
Provider Entity Type
Organization
Address
107 Front St, Vidalia, LA, 71373-2836
Phone Number
318-336-2218
Fax Number
Provider Enumeration Date
09/27/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
03027576 05 MS
190020258Z 01 LA BLUE CROSS PROVIDER NUMBE
1464015 05 LA
institution
Provider Business Practice Location Address Details
Address
107 Front St
City
Vidalia
State
Louisiana
Zip
71373-2836
Phone Number
318-336-2218
Fax Number
person
Provider Business Mailing Address Details
Address
107 Front St
City
Vidalia
State
Louisiana
Zip
71373-2836
Phone Number
318-336-2218
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Ambulatory Surgical
Taxonomy
261QA1903X
License No.
128 (Louisiana)
Definition
Definition to come...
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