Healthcare Provider Details

I. General information

NPI: 1891227310
Provider Name (Legal Business Name): NEW RIVER ULTRASONICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 MAIN ST W
OAK HILL WV
25901-2935
US

IV. Provider business mailing address

140 JOHN ST
OAK HILL WV
25901-2514
US

V. Phone/Fax

Practice location:
  • Phone: 304-575-6923
  • Fax:
Mailing address:
  • Phone: 304-575-6923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StateWV

VIII. Authorized Official

Name: MRS. SHELLI K PAULEY
Title or Position: SONOGRAPHER
Credential: DMS
Phone: 304-575-6923