Provider Demographics
NPI:1861680662
Name:RIVERSBEND HOSPITALISTS P.C.
Entity Type:Organization
Organization Name:RIVERSBEND HOSPITALISTS P.C.
Other - Org Name:RBH MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAPHAEL
Authorized Official - Middle Name:IWEBUNOR
Authorized Official - Last Name:AGADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-943-8127
Mailing Address - Street 1:3611 BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-1344
Mailing Address - Country:US
Mailing Address - Phone:804-526-2816
Mailing Address - Fax:804-526-2817
Practice Address - Street 1:3611 BOULEVARD
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-1344
Practice Address - Country:US
Practice Address - Phone:804-526-2816
Practice Address - Fax:804-526-2817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-06
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101840582208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C10386Medicare PIN