Organization
RIVERSIDE MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY J CRAWFORD (CEO)
(859) 441-8876
Entity
Organization
Contact information
Practice address
77 CRYE LEIKE DR, FORT OGLETHORPE, GA 30742-4055
(762) 257-2100
(762) 320-5366
Mailing address
1019 TOWN DR, HIGHLAND HEIGHTS, KY 41076-9114
(859) 441-8876
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
04/09/2021
Last updated
04/14/2021
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