| Organization Name: | RIVER PARK ASC LLC |
| NPI Number: | 1144216847 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARCI MCGRAW (CEO) |
| Mailing Address: | 107 Front St Ste.1100 Vidalia |
| State: | LA US |
| Postal Code: | 713732836 |
| Phone Number: | 3183362218 |
| Fax Number: | |
| NPI Enumeration Date: | 09/27/2005 |
| NPI Last Update Date: | 02/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 128 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |