Provider Demographics
NPI:1477547859
Name:RIVERSIDE CRITICAL CARE PHYSICIANS, INC
Entity Type:Organization
Organization Name:RIVERSIDE CRITICAL CARE PHYSICIANS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:N
Authorized Official - Last Name:RUFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-566-4691
Mailing Address - Street 1:PO BOX 20452
Mailing Address - Street 2:RCCP - CRED
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-0452
Mailing Address - Country:US
Mailing Address - Phone:614-442-2406
Mailing Address - Fax:614-442-2410
Practice Address - Street 1:3535 OLENTANGY RIVER RD
Practice Address - Street 2:RMH 4 TOWER ICU
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3908
Practice Address - Country:US
Practice Address - Phone:614-566-4691
Practice Address - Fax:614-566-6854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-31
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CB6003OtherMCR RR PIN
OH0822720Medicaid
OH9927541Medicare PIN