# RUSSELL COUNTY MEDICAL CENTER, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RUSSELL COUNTY MEDICAL CENTER, INC
- **Other names:** Riverside Community Medical Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1184692600
- **Legal business name:** RUSSELL COUNTY MEDICAL CENTER, INC
- **Authorized official:** DAVID MILLER (SENIOR VP, GROUP OPERATIONS)
- **Authorized official phone:** (888) 373-9600

## Contact information

- **Practice address:** HIGHWAY 58, 1 RIVERSIDE DRIVE, RIVERSIDE SHOPPING CENTER, ST PAUL, VA 24283
- **Practice address phone:** (276) 762-2300
- **Mailing address:** PO BOX 3600, LEBANON, VA 24266-0200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | H1892 | VA | Yes |

## Other

- **Enumeration date:** 03/10/2006
- **Last updated:** 11/27/2007