Healthcare Provider Details

I. General information

NPI: 1881756989
Provider Name (Legal Business Name): RIVERSIDE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 MAIN ST
FRANKLINTON LA
70438-3688
US

IV. Provider business mailing address

1900 MAIN ST
FRANKLINTON LA
70438-3688
US

V. Phone/Fax

Practice location:
  • Phone: 985-839-4431
  • Fax: 985-839-0319
Mailing address:
  • Phone: 985-839-4431
  • Fax: 985-839-0319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. STACEY K MCGRAW
Title or Position: BUSINESS OFFICE DIRECTOR
Credential:
Phone: 985-795-4168