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General NPI Number Information
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NPI Number | 1316944846
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Entity Type | Organization
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Legal Business Name | RIVER MEDICAL INC
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 415 EL CAMINO WAY
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-4628
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Country | US
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Telephone | 928-855-0048
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Fax | 928-855-5419
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Provider Business Mailing Address
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Address Line | PO BOX 847102
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City | DALLAS
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State | TX
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Zip | 75284-7102
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Country | US
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Telephone | 800-913-9106
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Fax |
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | TIMOTHY JOSEPH DORN
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Credential |
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Telephone | 833-703-2294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 94
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License Number State | AZ
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