Provider Demographics
NPI:1376880112
Name:DELTA MEDICAL/RFG, LLC
Entity Type:Organization
Organization Name:DELTA MEDICAL/RFG, LLC
Other - Org Name:DELTA MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KERWIN
Authorized Official - Middle Name:F
Authorized Official - Last Name:RIGAUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-754-3180
Mailing Address - Street 1:134 ORIENT AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-3612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:134 ORIENT AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-3612
Practice Address - Country:US
Practice Address - Phone:862-754-3180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies