Provider Demographics
NPI:1528536612
Name:RIVER CITY MEDICAL LLC
Entity Type:Organization
Organization Name:RIVER CITY MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:CREWS
Authorized Official - Last Name:HARAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-721-0622
Mailing Address - Street 1:7719 ANOKA RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-3301
Mailing Address - Country:US
Mailing Address - Phone:804-721-0622
Mailing Address - Fax:
Practice Address - Street 1:7719 ANOKA RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-3301
Practice Address - Country:US
Practice Address - Phone:804-721-0622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies