Organization
RIVERSIDE HEALTHCARE SERVICES INC
Active
Other names
Riverside Pharmacy Services
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE BOGGS (ADMINISTRATOR)
(757) 594-4600
Entity
Organization
Contact information
Practice address
848 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1303
(757) 594-3944
(757) 534-6330
Mailing address
608 DENBIGH BLVD, STE 800, NEWPORT NEWS, VA 23608-4410
(757) 875-7545
(757) 875-7553
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
0201003424
VA
333600000X
Pharmacy
0201003424
VA
3336H0001X
Home Infusion Therapy Pharmacy
Primary
0201003424
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083852586
—
VA
01
—
4841777
NDPDP
VA
Enumeration date
01/22/2009
Last updated
09/20/2010
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