Organization
RIVERSIDE RETIREMENT SERVICE
Active
Parent organization
RIVERSIDE HEALTHCARE ASSOCIATION
Other names
Riverside PACE
Organization subpart
Yes
Provider details
NPI number
Legal business name
RIVERSIDE HEALTHCARE ASSOCIATION
Authorized official
CRAIG CONNORS (VP CBS)
(757) 875-2070
Entity
Organization
Contact information
Practice address
439 ORIANA ROAD, NEWPORT NEWS, VA 23608
(757) 875-2000
Mailing address
1020 OLD DENBIGH BLVD, NEWPORT NEWS, VA 23608
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H8655
MEDICARE CONTRACT NUMBER
—
Enumeration date
02/10/2012
Last updated
02/10/2012
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