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General NPI Number Information
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NPI Number | 1134223795
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Entity Type | Organization
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Legal Business Name | RIVERBEND MEDICAL GROUP, INC
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 01/18/2021
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Provider Practice Location Address
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Address Line | 230 MAIN ST
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City | AGAWAM
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State | MA
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Zip | 01001
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Country | US
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Telephone | 413-789-6800
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Fax | 413-789-5171
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Provider Business Mailing Address
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Address Line | 230 MAIN ST
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City | AGAWAM
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State | MA
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Zip | 01001-1838
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Country | US
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Telephone | 413-789-6800
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Fax | 413-789-5171
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Authorized Official
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Title or Position | REGIONAL DIRECTOR OF REIMBURSEMENT
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Name | JAMES M HARRIS
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Credential |
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Telephone | 860-714-4396
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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 |
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License Number State |
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