Healthcare Provider Details

I. General information

NPI: 1548743065
Provider Name (Legal Business Name): RIVER CITY MIDWIFERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2018
Last Update Date: 09/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6219 LAKESIDE AVE
RICHMOND VA
23228-5238
US

IV. Provider business mailing address

6219 LAKESIDE AVE
RICHMOND VA
23228-5238
US

V. Phone/Fax

Practice location:
  • Phone: 804-601-6992
  • Fax: 888-208-8058
Mailing address:
  • Phone: 804-601-6992
  • Fax: 888-208-8058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: MRS. ADRIANNA ROSS
Title or Position: MIDWIFE
Credential: CPM, LM
Phone: 804-601-6992