| Northwood Medical Center | |
|
2916 N. Trenton St. Ruston LA 71270-2444 | |
| (318) 254-2892 | |
| (318) 254-2898 |
| Full Name | Northwood Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2916 N. Trenton St., Ruston, Louisiana |
| Authorized Official Name and Position | Benson A. Grigsby (PRESIDENT) |
| Authorized Official Contact | 3182542892 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwood Medical Center 2916 N. Trenton St. Ruston LA 71270-2444 Ph: (318) 254-2892 | Northwood Medical Center 2916 N. Trenton St. Ruston LA 71270-2444 Ph: (318) 254-2892 |
| NPI Number | 1881800761 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 0547358343 |
|---|---|
| Medicare Enrollment ID | O20071112000591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881800761 | NPI | - | NPPES |
| 018222 | Other | LA | MEDICAL LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 018222 (Louisiana) | Primary |
| Provider Name | Benson Grigsby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487687513 PECOS PAC ID: 4880612241 Enrollment ID: I20061102000465 |
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