Organization
RIVER HOSPITAL, INC.
Active
Other names
River Hospital Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
CARRIE BETH BOVA (DIRECTOR, REVENUE CYCLE MANAGEMENT)
(315) 482-1207
Entity
Organization
Contact information
Practice address
4 FULLER ST, ALEXANDRIA BAY, NY 13607-1391
(315) 482-1207
(315) 482-3727
Mailing address
4 FULLER ST, ALEXANDRIA BAY, NY 13607-1316
(315) 482-2511
(315) 482-4981
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
—
207QA0505X
Adult Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
208000000X
Pediatrics Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02381
HPSA ID MUA
NY
05
—
02392854
—
NY
05
—
03011387
—
NY
01
—
1367324943
HPSA
NY
01
—
33D1050774
CLIA
NY
Enumeration date
06/22/2012
Last updated
09/30/2020
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