Provider Demographics
NPI:1225796196
Name:LITTLE RIVER MEDICAL, LLC
Entity Type:Organization
Organization Name:LITTLE RIVER MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:MARCH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:540-230-5186
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:FLOYD
Mailing Address - State:VA
Mailing Address - Zip Code:24091-0608
Mailing Address - Country:US
Mailing Address - Phone:540-230-5186
Mailing Address - Fax:877-728-4339
Practice Address - Street 1:464 CHRISTIANSBURG PIKE NE
Practice Address - Street 2:
Practice Address - City:FLOYD
Practice Address - State:VA
Practice Address - Zip Code:24091-3737
Practice Address - Country:US
Practice Address - Phone:540-230-5186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-07
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty