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General NPI Number Information
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NPI Number | 1104888536
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Entity Type | Organization
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Legal Business Name | RIVERWOOD EMERGENCY SERVICES INC.
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Dates
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Enumeration Date | 04/03/2006
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 12621 ECKEL JUNCTION RD
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City | PERRYSBURG
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State | OH
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Zip | 43551-1304
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Country | US
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Telephone | 567-368-1008
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 365
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City | PERRYSBURG
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State | OH
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Zip | 43552-0365
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Country | US
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Telephone | 567-368-1008
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | JAY TAYLOR
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Credential | MD
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Telephone | 567-368-1008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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