Organization
RILEY-WHITE, INC.
Active
Other names
R-W Vital Care II
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD RILEY (PRESIDENT)
(270) 726-7626
Entity
Organization
Contact information
Practice address
201 PARK ST, BOWLING GREEN, KY 42101-1759
(270) 726-7626
Mailing address
PO BOX 5047, MERIDIAN, MS 39302-5047
(800) 447-4095
(601) 482-7490
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
P02496
KY
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
P02496
KY
332BX2000X
Oxygen Equipment & Supplies (DME)
P02496
KY
333600000X
Pharmacy
P02496
KY
3336C0003X
Community/Retail Pharmacy
P02496
KY
3336H0001X
Home Infusion Therapy Pharmacy
P02496
KY
3336M0002X
Mail Order Pharmacy
P02496
KY
3336S0011X
Specialty Pharmacy
P02496
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000323901
BCBS NPAR (HIT)
KY
01
—
4052292
BCBS NON PAR
TN
05
—
54028618
—
KY
05
—
90341140
—
KY
01
—
A546/000000070079
BCBS
KY
Enumeration date
07/14/2006
Last updated
04/24/2012
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