ROCKDALE BLACKHAWK LLC (NPI# 1174953467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174953467 |
| Entity Type | Organization |
| Organization Name | ROCKDALE BLACKHAWK LLC |
| Other Organization Name | LITTLE RIVER HEALTHCARE KING'S DAUGHTERS CLINIC |
| Practice Address |
1717 Sw H K Dodgen Loop Temple TX 76502-1838 |
| Practice Telephone | 2542982599 |
| Mailing Telephone | 2542982599 |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2015-05-14 |
| Authorized Official Name | JEFFREY P MADISON (CEO) |
| Authorized Official Telephone | 5124464500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| Little River Healthcare King's Daughters Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073924932 | Rockdale Blackhawk LLC | Prosthetic/Orthotic Supplier | 1512 Leander Rd, Georgetown, TX 78628-8801 | 2014-05-14 |
| 1407072358 | Rockdale Blackhawk LLC | Clinic/Center | 708 N Crockett Ave, Cameron, TX 76520-2551 | 2007-04-18 |
| 1679904577 | Rockdale Blackhawk LLC | Durable Medical Equipment & Medical Supplies | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2013-12-03 |
| 1811339831 | Rockdale Blackhawk LLC | Prosthetic/Orthotic Supplier | 1904 Railroad St, Georgetown, TX 78626-7718 | 2013-07-18 |
| 1033483086 | Rockdale Blackhawk LLC | General Practice | 5656 Bee Cave Rd, Suite M-300, West Lake Hills, TX 78746-5280 | 2012-03-07 |
| 1245514975 | Rockdale Blackhawk LLC | Clinic/Center | 715 Discovery Blvd, Suite 102, Cedar Park, TX 78613-2287 | 2011-09-29 |
| 1831479682 | Rockdale Blackhawk LLC | Clinic/Center | 1528 Leander Rd, Georgetown, TX 78628-8801 | 2011-08-25 |
| 1295015055 | Rockdale Blackhawk LLC | Clinic/Center | 3101 Highway 71 E, Suite 101, Bastrop, TX 78602-5156 | 2011-08-25 |
| 1083903843 | Rockdale Blackhawk LLC | Physiological Laboratory | 3692 E Sam Houston Pkwy S, Pasadena, TX 77505-3137 | 2011-04-01 |
| 1427353770 | Rockdale Blackhawk LLC | Clinic/Center | 3101 Highway 71 E, Suite 108, Bastrop, TX 78602-5156 | 2011-01-18 |
| Street Address |
1717 SW H K DODGEN LOOP |
| City | TEMPLE |
| State | TX |
| Zip Code | 76502-1838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043206121 | Edward T. Mccaffrey | Podiatrist | 1717 Sw H K Dodgen Loop, Temple, TX 76502-1838 | 2005-09-23 |
| 1326442195 | Little River Medical Group | Durable Medical Equipment & Medical Supplies | 1717 Sw H K Dodgen Loop, Suite 103, Temple, TX 76502-1838 | 2014-10-22 |
| 1851577282 | Shelley Mullen Howell D.o., Pa | Clinic/Center | 1717 Sw H K Dodgen Loop, Suite 114b, Temple, TX 76502-1838 | 2008-01-16 |
| 1801012257 | Physicians of King's Daughters, Pa | Durable Medical Equipment & Medical Supplies | 1717 Sw H K Dodgen Loop, Temple, TX 76502-1838 | 2007-04-17 |
| 1194750109 | Physicians of King's Daughters, P.a. | Ophthalmology | 1717 Sw H K Dodgen Loop, Temple, TX 76502-1838 | 2006-07-11 |
| 1295710028 | John M. Balbo | Audiologist | 1717 Sw H K Dodgen Loop, Temple, TX 76502-1838 | 2005-12-14 |
| 1902881550 | John V Elwood | Psychologist | 1717 Sw H K Dodgen Loop, Suite 110, Temple, TX 76502-1838 | 2005-12-07 |
| 1790771715 | Richard T. Tay | Internal Medicine | 1717 Sw H K Dodgen Loop, Temple, TX 76502-1838 | 2005-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710850 | Bih Mobanoe Chi | Pharmacist | 6801 West Adams Avenue, Temple, TX 76502 | 2020-11-06 |
| 1639705403 | Robert David Pompella | Chiropractor | 4805 Stone Ridge Dr, Temple, TX 76502 | 2020-03-12 |
| 1275167488 | Luong Dental, LLC | Dentist | 5297 S. 31st Street, Ste 111, Temple, TX 76502 | 2020-02-26 |
| 1093357931 | Ryan T Stephens Dmd Pllc | Dentist | 5408 W. Adams Suite 102, Temple, TX 76502 | 2019-10-11 |
| 1164071817 | Danyelle Denise Pividori | Licensed Vocational Nurse | 992 Marlandwood Rd, Temple, TX 76502 | 2019-09-05 |
| 1831670652 | Jane Lida Jarosz | Registered Nurse | 99 Marlandwood, Temple, TX 76502 | 2018-08-29 |
| 1043791809 | Elsa Gamban Baker | Licensed Practical Nurse | 5711 Hopkins Dr, Temple, TX 76502 | 2018-08-28 |
| 1659859288 | Laura Bright | Licensed Vocational Nurse | 990 Marlanwood, Temple, TX 76502 | 2018-08-06 |
| 1811489974 | Rockdale Blackhawk, LLC | Clinic/Center | 1909 Sw Hk Dodgen Loop, Temple, TX 76502 | 2018-06-05 |
| 1871094573 | Moc Temple, LLC | Skilled Nursing Facility | 725 Marlandwood Rd., Temple, TX 76502 | 2018-02-27 |
| Find all providers in zip 76502 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558908962 | Crystal Hernandez | Durable Medical Equipment & Medical Supplies | 1907 Ramcon Dr, Temple, TX 76504-7154 | 2019-12-04 |
| 1467606145 | Hanger Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 2707 S 37th St Ste C, Temple, TX 76504-7111 | 2008-11-07 |
| 1295981082 | Giant Food Stores, LLC | Durable Medical Equipment & Medical Supplies | 4320 N. 5th Street Hwy, Temple, PA 19560 | 2008-08-12 |
| 1881867687 | Donald A Rupprecht | Durable Medical Equipment & Medical Supplies | 1900 S 1st St, Temple, TX 76504-7449 | 2008-04-12 |
| 1881862647 | The Bedding Express | Durable Medical Equipment & Medical Supplies | 4211 S General Bruce Dr, Temple, TX 76502-1402 | 2008-02-14 |
| 1689882193 | Cvs Pharmacy Inc. | Durable Medical Equipment & Medical Supplies | 3550 S General Bruce Dr, Temple, TX 76504-5138 | 2007-05-18 |
| 1740492800 | Advanced Medical Sales, LLC | Durable Medical Equipment & Medical Supplies | 1005 Marlandwood Rd, Suite 108, Temple, TX 76502-7270 | 2007-05-03 |
| 1992852339 | In Vision Eye Care, LLC | Durable Medical Equipment & Medical Supplies | 2924 S 31st St, Temple, TX 76502-1861 | 2007-01-05 |
| 1003833278 | Wal-mart Stores Texas LLC | Durable Medical Equipment & Medical Supplies | 3401 S 31st St, Temple, TX 76502-1902 | 2006-07-16 |
| 1861419004 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 5314 Allentown Pike, Temple, PA 19560-1249 | 2006-07-16 |
| Find all providers in TEMPLE | ||||
Please comment or provide details below to improve the information on ROCKDALE BLACKHAWK LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.