Provider Demographics
NPI:1255708616
Name:RIVER VALLEY HEALTHCARE ASSOCIATES, PC
Entity type:Organization
Organization Name:RIVER VALLEY HEALTHCARE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:EHIKIOYA
Authorized Official - Middle Name:O
Authorized Official - Last Name:OSEMOBOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-616-8991
Mailing Address - Street 1:28 TOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:VA
Mailing Address - Zip Code:24084-6069
Mailing Address - Country:US
Mailing Address - Phone:540-616-8991
Mailing Address - Fax:
Practice Address - Street 1:28 TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:VA
Practice Address - Zip Code:24084-6069
Practice Address - Country:US
Practice Address - Phone:540-616-8991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care