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General NPI Number Information
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NPI Number | 1427013838
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Entity Type | Organization
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Legal Business Name | RIVERVIEW ANESTHESIA, INC.
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 03/11/2010
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Provider Practice Location Address
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Address Line | 4800 48TH ST
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City | VALLEY
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State | AL
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Zip | 36854-3666
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Country | US
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Telephone | 334-756-1848
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Fax | 334-756-1854
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Provider Business Mailing Address
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Address Line | PO BOX 661495
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City | BIRMINGHAM
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State | AL
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Zip | 35266-1495
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Country | US
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Telephone | 205-979-5882
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Fax | 205-979-1248
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES M HENDERSON JR.
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Credential | CRNA
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Telephone | 334-756-1848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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