# NEW RIVER MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235468323
- **Authorized official:** MRS. CAROLYN P. GARDNER (INSURANCE CLERK)
- **Authorized official phone:** (540) 980-0550

## Contact information

- **Practice address:** 101 1ST ST NW, PULASKI, VA 24301-1641
- **Practice address phone:** (540) 980-0550
- **Practice address fax:** (540) 980-5010
- **Mailing address:** P.O. BOX 1641, 101 1ST ST. NW, PULASKI, VA 24301-1641
- **Mailing address phone:** (540) 980-0550
- **Mailing address fax:** (540) 980-5010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/18/2009
- **Last updated:** 12/18/2009