# RIVERSIDE PHYSICIAN SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Nursing Home Hosfield
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669646949
- **Authorized official:** MICHAEL J DOUCETTE (VICE PRESIDENT)
- **Authorized official phone:** (757) 594-4006

## Contact information

- **Practice address:** 900 MAIN STREET, WEST POINT, VA 23181
- **Practice address phone:** (757) 594-4006
- **Mailing address:** 856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
- **Mailing address phone:** (757) 594-4006
- **Mailing address fax:** (757) 594-2195

## Taxonomy

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

## Other

- **Enumeration date:** 04/17/2008
- **Last updated:** 04/17/2008