Provider Demographics
NPI:1225422777
Name:GOLDEN STONE LLC
Entity Type:Organization
Organization Name:GOLDEN STONE LLC
Other - Org Name:NEW RIVER NEPHROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FERAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-981-9394
Mailing Address - Street 1:4311 APPLETON AVE NW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24017-2111
Mailing Address - Country:US
Mailing Address - Phone:540-981-9394
Mailing Address - Fax:540-344-7154
Practice Address - Street 1:4311 APPLETON AVE NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24017-2111
Practice Address - Country:US
Practice Address - Phone:540-981-9394
Practice Address - Fax:540-344-7154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-23
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101257788207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty