Organization
RIVERSIDE HEALTHCARE SERVICES
Active
Other names
RIVERSIDE PHARMACY SERVICES-RICHMOND
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE BOGGS (ADMINISTRATOR)
(757) 594-4600
Entity
Organization
Contact information
Practice address
1300 MACTAVISH AVE, RICHMOND, VA 23230-4633
(804) 977-5901
(804) 977-5910
Mailing address
1300 MACTAVISH AVE, RICHMOND, VA 23230-4633
(804) 977-5901
(804) 977-5910
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
0201004270
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4841599
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/12/2009
Last updated
08/27/2012
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