Provider Demographics
NPI:1275104481
Name:RIVERVIEW SERVICES, LLC
Entity Type:Organization
Organization Name:RIVERVIEW SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:606-643-6104
Mailing Address - Street 1:417 RIVER DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:KY
Mailing Address - Zip Code:40336-1272
Mailing Address - Country:US
Mailing Address - Phone:606-723-0695
Mailing Address - Fax:606-723-0043
Practice Address - Street 1:417 RIVER DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:KY
Practice Address - Zip Code:40336-1272
Practice Address - Country:US
Practice Address - Phone:606-723-0695
Practice Address - Fax:606-723-0043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-08
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty