Organization
RIVERSIDE HOSPITAL INC
Active
Parent organization
RIVERSIDE HOSPITAL INC
Other names
RIVERSIDE PATIENT TRANSPORT
Organization subpart
Yes
Provider details
NPI number
Legal business name
RIVERSIDE HOSPITAL INC
Authorized official
WADE DUDLEY BROUGHMAN (EXECUTIVE VICE PRESIDENT/CFO)
(757) 875-7543
Entity
Organization
Contact information
Practice address
500 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1929
(757) 594-3756
(757) 594-2196
Mailing address
608 DENBIGH BLVD, SUITE 800, NEWPORT NEWS, VA 23608-4410
(757) 875-7545
(757) 875-7553
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1293
VA
Other
Enumeration date
12/10/2009
Last updated
12/10/2009
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