Provider Demographics
NPI:1932372968
Name:RIVERSIDE HEALTH CENTER
Entity Type:Organization
Organization Name:RIVERSIDE HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LUANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-962-1660
Mailing Address - Street 1:322 W RIVERSIDE ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24426-1219
Mailing Address - Country:US
Mailing Address - Phone:540-962-1660
Mailing Address - Fax:540-962-1570
Practice Address - Street 1:322 W RIVERSIDE ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24426-1219
Practice Address - Country:US
Practice Address - Phone:540-962-1660
Practice Address - Fax:540-962-1570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health