Organization
RIVERSIDE PHYSICIAN SERVICES INC
Active
Parent organization
RIVERSIDE HEALTHCARE ASSC. INC
Other names
Riverside Advanced Wound Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
RIVERSIDE HEALTHCARE ASSC. INC
Authorized official
CAROL SPRATLEY (CREDENTIALING SPECIALIST)
(757) 316-5960
Entity
Organization
Contact information
Practice address
500 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1929
(757) 612-6390
(757) 933-8346
Mailing address
856 J CLYDE MORRIS BLVD STE A, NEWPORT NEWS, VA 23601-1318
(757) 316-5800
(757) 534-5190
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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