Provider Demographics
NPI:1265641609
Name:RIVERSIDE UROLOGY, INC
Entity Type:Organization
Organization Name:RIVERSIDE UROLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:RIEMENSCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-442-3000
Mailing Address - Street 1:4845 KNIGHTSBRIDGE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-2463
Mailing Address - Country:US
Mailing Address - Phone:614-442-3000
Mailing Address - Fax:614-442-3920
Practice Address - Street 1:4845 KNIGHTSBRIDGE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2463
Practice Address - Country:US
Practice Address - Phone:614-442-3000
Practice Address - Fax:614-442-3920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35028295R208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty