Provider Demographics
NPI:1093367963
Name:RICHLAND PARISH HOSPITAL SERVICE DISTRICT NO. 1-B
Entity type:Organization
Organization Name:RICHLAND PARISH HOSPITAL SERVICE DISTRICT NO. 1-B
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TEDETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-728-8140
Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:RAYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71269-0388
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 ELLINGTON DR
Practice Address - Street 2:
Practice Address - City:RAYVILLE
Practice Address - State:LA
Practice Address - Zip Code:71269-3632
Practice Address - Country:US
Practice Address - Phone:318-728-4181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICHLAND PARISH HOSPITAL SERVICE DISTRICT NO. 1-B
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty