Provider Demographics
NPI:1457127359
Name:RIVERMED SUPPLIES AND LOGISTICS
Entity Type:Organization
Organization Name:RIVERMED SUPPLIES AND LOGISTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:MYKA
Authorized Official - Last Name:TEXAS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:781-308-8434
Mailing Address - Street 1:82 BAY DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-4182
Mailing Address - Country:US
Mailing Address - Phone:781-308-8434
Mailing Address - Fax:
Practice Address - Street 1:4 FRANK LEARY WAY
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4512
Practice Address - Country:US
Practice Address - Phone:781-308-8434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS TRANSPORT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies