Provider Demographics
NPI:1063823508
Name:RIVER VALLEY RHEUMATOLOGY & INFUSIONS, INC
Entity Type:Organization
Organization Name:RIVER VALLEY RHEUMATOLOGY & INFUSIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CALLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-399-0652
Mailing Address - Street 1:960 LIBERTY ST SE
Mailing Address - Street 2:#200
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4171
Mailing Address - Country:US
Mailing Address - Phone:503-399-0652
Mailing Address - Fax:503-373-3852
Practice Address - Street 1:960 LIBERTY ST SE
Practice Address - Street 2:#200
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4171
Practice Address - Country:US
Practice Address - Phone:503-399-0652
Practice Address - Fax:503-373-3852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty