Healthcare Provider Details

I. General information

NPI: 1356412787
Provider Name (Legal Business Name): RILEY-WHITE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 PARK ST STE 101
BOWLING GREEN KY
42101-1742
US

IV. Provider business mailing address

201 PARK ST STE 101
BOWLING GREEN KY
42101-1742
US

V. Phone/Fax

Practice location:
  • Phone: 270-781-3095
  • Fax: 800-831-5467
Mailing address:
  • Phone: 270-781-3095
  • Fax: 800-831-5467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberP02386
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberP02386
License Number StateKY

VIII. Authorized Official

Name: DONALD GLENN RILEY
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 270-781-3095