RIVERPARK COMMUNITY CATH LAB, LLC (NPI# 1730276965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730276965 |
| Entity Type | Organization |
| Organization Name | RIVERPARK COMMUNITY CATH LAB, LLC |
| Practice Address |
107 Front St Vidalia LA 71373-2836 |
| Mailing Address |
Po Box 35 107 Front St. Vidalia LA 71373-0035 |
| Practice Telephone | 6014451703 |
| Practice Fax Number | 6014456726 |
| Mailing Telephone | 6014451703 |
| Mailing Fax Number | 6014456726 |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. SCOTT WHITTEMORE (CHIEF FINACIAL OFFICER) |
| Authorized Official Telephone | 6014456203 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities |
| Street Address |
107 FRONT ST |
| City | VIDALIA |
| State | LA |
| Zip Code | 71373-2836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447251996 | Iley Floyd Dillon | Internal Medicine | 107 Front St, Suite 2109, Vidalia, LA 71373-2836 | 2005-08-09 |
| 1992326359 | Riverpark Dermatology Services LLC | Dermatology | 107 Front St, Rm 1-129, Vidalia, LA 71373 | 2020-04-27 |
| 1356875637 | Perfusion Vascular Vidalia LLC | Surgery | 107 Front St, Vidalia, LA 71373-2836 | 2017-04-13 |
| 1275985012 | Riverfront Urgent Care Center LLC | Orthopaedic Surgery | 107 Front St, Ste 2138, Vidalia, LA 71373-2836 | 2016-07-05 |
| 1407249766 | Riverpark Counseling LLC | Social Worker | 107 Front St, Ste 2134, Vidalia, LA 71373-2836 | 2015-03-11 |
| 1700937950 | Michael R Wimberly II | Physical Therapist | 107 Front St, Suite 230, Vidalia, LA 71373-2836 | 2007-01-15 |
| 1336209550 | J H Fairbanks, Md Pllc | Orthopaedic Surgery | 107 Front St, Suite 230, Vidalia, LA 39120 | 2006-12-11 |
| 1649341082 | Lisa Cazalot | Nurse Practitioner | 107 Front St, Vidalia, LA 71373-2836 | 2006-11-09 |
| 1255421038 | Riverpark Laboratory Services | Clinical Medical Laboratory | 107 Front St, Vidalia, LA 71373-2836 | 2006-10-13 |
| 1669491288 | John H Fairbanks | Orthopaedic Surgery | 107 Front St, Suite 2134, Vidalia, LA 71373-2836 | 2006-07-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710513494 | Total Urgent Care | Clinic/Center | 4014 Carter Street, Vidalia, LA 71373 | 2020-03-13 |
| 1609412097 | Hulin Urgent Care Services, LLC | Clinic/Center | 4319 Highway 84, Vidalia, LA 71373 | 2019-11-21 |
| 1720562556 | Neashion Marie Davis | Counselor | 1644 B Carter Street. Suite #2, Vidalia, LA 71373 | 2018-09-18 |
| 1992292403 | Angelica Francheska Woods | Counselor | 1644 B. Carter Street Suite 2, Vidalia, LA 71373 | 2018-04-19 |
| 1164973780 | Linda Sherbia | Counselor | 1644 B Carter St., Suite 2, Vidalia, LA 71373 | 2016-10-19 |
| 1518418045 | Cheryl Clark | Case Manager/Care Coordinator | 1644 B Carter Suite 2, Vidalia, LA 71373 | 2016-10-19 |
| 1972054500 | Sherry Cade | Counselor | 1644 B Carter Street, Suite 2, Vidalia, LA 71373 | 2016-10-19 |
| 1457801136 | Sarai Johnson | Counselor | 1644 B Carter Street Suite 2, Vidalia, LA 71373 | 2016-10-06 |
| 1053766410 | Erin Fournet Woodruff | Physical Therapist | 402 Holly Street, Vidalia, LA 71373 | 2016-05-04 |
| 1184084113 | Troy Nolan Thomas Jr. | Counselor | 4012 Carter St., Vidalia, LA 71373 | 2016-03-03 |
| Find all providers in zip 71373 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275156952 | Just Health | Clinic/Center | 4001 Carter St Rm 7, Vidalia, LA 71373-3021 | 2020-05-28 |
| 1982223012 | Just Health | Clinic/Center | 4001 Carter St Rm 9, Vidalia, LA 71373-3021 | 2020-04-09 |
| 1609138692 | Mercy Medical Clinic | Clinic/Center | 300 Arlington Dr, Vidalia, GA 30474-8935 | 2012-06-14 |
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| 1861016164 | Just Health | Clinic/Center | 411 Bolivar Bishop Dr, Deridder, LA 70634 | 2020-06-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.