Provider Demographics
NPI:1720406267
Name:RIVER CITY MEDICAL ASSOCIATES, INC
Entity Type:Organization
Organization Name:RIVER CITY MEDICAL ASSOCIATES, INC
Other - Org Name:RIVER CITY PAIN PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:VIPUL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:904-683-0394
Mailing Address - Street 1:644 CESERY BLVD
Mailing Address - Street 2:STE 330
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-7116
Mailing Address - Country:US
Mailing Address - Phone:904-683-0394
Mailing Address - Fax:
Practice Address - Street 1:6947 MERRILL RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-2684
Practice Address - Country:US
Practice Address - Phone:904-743-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty