Provider Demographics
NPI:1326478181
Name:RIVERS, CAMMIE
Entity Type:Individual
Prefix:
First Name:CAMMIE
Middle Name:
Last Name:RIVERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 HEMLOCK RADL
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-8689
Mailing Address - Country:US
Mailing Address - Phone:352-304-4466
Mailing Address - Fax:352-680-0002
Practice Address - Street 1:48 HEMLOCK RADL
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34472-8689
Practice Address - Country:US
Practice Address - Phone:352-304-4466
Practice Address - Fax:352-680-0002
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-14
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No374U00000XNursing Service Related ProvidersHome Health Aide