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General NPI Number Information
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NPI Number | 1073680864
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Entity Type | Organization
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Legal Business Name | RILEY-WHITE INC
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 153 PARK SQUARE NW
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City | RUSSELLVILLE
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State | KY
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Zip | 42276
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Country | US
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Telephone | 270-726-7626
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Fax | 270-726-7879
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Provider Business Mailing Address
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Address Line | 153 PARK SQUARE NW
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City | RUSSELLVILLE
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State | KY
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Zip | 42276
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Country | US
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Telephone | 270-726-7626
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Fax | 270-726-7879
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Authorized Official
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Title or Position | CO OWNER MANAGER
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Name | MR. JERROLD D WHITE
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Credential | RPH
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Telephone | 270-726-7626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | P06574
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License Number State | KY
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