Healthcare Provider Details

I. General information

NPI: 1366547747
Provider Name (Legal Business Name): RIVERSIDE HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 J CLYDE MORRIS BLVD
NEWPORT NEWS VA
23601
US

IV. Provider business mailing address

608 DENBIGH BLVD STE 800
NEWPORT NEWS VA
23608-4487
US

V. Phone/Fax

Practice location:
  • Phone: 757-594-2000
  • Fax: 757-594-2084
Mailing address:
  • Phone: 757-875-7545
  • Fax: 757-875-7553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: WALTER W AUSTIN JR.
Title or Position: CFO
Credential:
Phone: 757-875-7545