Provider Demographics
NPI:1245773811
Name:RIVER CITY VASCULAR SPECIALISTS LLC
Entity Type:Organization
Organization Name:RIVER CITY VASCULAR SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AYERDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-324-4493
Mailing Address - Street 1:1920 WARM SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-8031
Mailing Address - Country:US
Mailing Address - Phone:706-984-7000
Mailing Address - Fax:
Practice Address - Street 1:1920 WARM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8031
Practice Address - Country:US
Practice Address - Phone:706-984-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty