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General NPI Number Information
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NPI Number | 1255285086
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Entity Type | Organization
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Legal Business Name | RIVERTON GASTROENTEROLOGY CENTER LLC
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Dates
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Enumeration Date | 02/26/2026
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Last Update Date | 02/26/2026
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Provider Practice Location Address
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Address Line | 3741 W 12600 S STE 240
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City | RIVERTON
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State | UT
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Zip | 84065-7215
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Country | US
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Telephone | 904-631-7680
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Fax |
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Provider Business Mailing Address
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Address Line | 3741 W 12600 S STE 240
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City | RIVERTON
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State | UT
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Zip | 84065-7215
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Country | US
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Telephone | 904-631-7680
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | AMANDA HAMILTON
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Credential |
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Telephone | 904-631-7680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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