Provider Demographics
NPI:1114645116
Name:HALL RILEY COMPREHENSIVE HEALTHCARE LLC
Entity Type:Organization
Organization Name:HALL RILEY COMPREHENSIVE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNP, CEO
Authorized Official - Prefix:
Authorized Official - First Name:DALLAS
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-380-4256
Mailing Address - Street 1:695 E 16TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:PA
Mailing Address - Zip Code:18603-2320
Mailing Address - Country:US
Mailing Address - Phone:570-752-3640
Mailing Address - Fax:570-752-3425
Practice Address - Street 1:695 E 16TH ST STE B
Practice Address - Street 2:
Practice Address - City:BERWICK
Practice Address - State:PA
Practice Address - Zip Code:18603-2320
Practice Address - Country:US
Practice Address - Phone:570-752-3640
Practice Address - Fax:570-752-3425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-16
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty