Provider Demographics
NPI:1891227310
Name:NEW RIVER ULTRASONICS
Entity Type:Organization
Organization Name:NEW RIVER ULTRASONICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SONOGRAPHER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELLI
Authorized Official - Middle Name:K
Authorized Official - Last Name:PAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMS
Authorized Official - Phone:304-575-6923
Mailing Address - Street 1:140 JOHN ST
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:WV
Mailing Address - Zip Code:25901-2514
Mailing Address - Country:US
Mailing Address - Phone:304-575-6923
Mailing Address - Fax:
Practice Address - Street 1:138 MAIN ST W
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:WV
Practice Address - Zip Code:25901-2935
Practice Address - Country:US
Practice Address - Phone:304-575-6923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV261QR0200X, 261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile