1841216918 NPI number — RED RIVER VALLEY RADIOLOGY ASSOCIATES

Table of content: (NPI 1841216918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841216918 NPI number — RED RIVER VALLEY RADIOLOGY ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RED RIVER VALLEY RADIOLOGY ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841216918
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARIS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75461-0100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-785-6029
Provider Business Mailing Address Fax Number:
903-737-1938

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3015 NE LOOP 286
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARIS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75460
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-785-8521
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PARKHILL
Authorized Official First Name:
GAIL
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
903-785-6029

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 112539504 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00D29N . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 14203 . This is a "SCOTT & WHITE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100752010A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: CP7111 . This is a "RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 112539504 . This is a "SUPERIOR HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 018315100 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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