# RIVERSIDE PHYSICIAN SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RIVERSIDE HEALTHCARE ASSC. INC
- **Other names:** Riverside Advanced Wound Care Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1588210108
- **Legal business name:** RIVERSIDE HEALTHCARE ASSC. INC
- **Authorized official:** CAROL SPRATLEY (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (757) 316-5960

## Contact information

- **Practice address:** 500 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1929
- **Practice address phone:** (757) 612-6390
- **Practice address fax:** (757) 933-8346
- **Mailing address:** 856 J CLYDE MORRIS BLVD STE A, NEWPORT NEWS, VA 23601-1318
- **Mailing address phone:** (757) 316-5800
- **Mailing address fax:** (757) 534-5190

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QE0002X | Emergency Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/12/2019
- **Last updated:** 08/12/2019