Organization
RIVERVIEW ANESTHESIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES M HENDERSON JR. CRNA (PRESIDENT)
(334) 756-1848
Entity
Organization
Contact information
Practice address
4800 48TH ST, VALLEY, AL 36854-3666
(334) 756-1848
(334) 756-1854
Mailing address
PO BOX 661495, BIRMINGHAM, AL 35266-1495
(205) 979-5882
(205) 979-1248
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529918490
—
AL
01
—
DB2207
RAILROAD MEDICARE GROUP #
AL
01
—
F874
BC BS AL COMMON PAY #
AL
Enumeration date
04/19/2006
Last updated
03/11/2010
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