Healthcare Provider Details

I. General information

NPI: 1386309185
Provider Name (Legal Business Name): RIVERVIEW SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2021
Last Update Date: 11/05/2021
Certification Date: 11/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 RIVER DR
IRVINE KY
40336-1272
US

IV. Provider business mailing address

417 RIVER DR
IRVINE KY
40336-1272
US

V. Phone/Fax

Practice location:
  • Phone: 606-723-0695
  • Fax: 606-723-0043
Mailing address:
  • Phone: 606-723-0695
  • Fax: 606-723-0043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PAMELA JONES
Title or Position: OWNER
Credential:
Phone: 606-723-0695