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General NPI Number Information
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NPI Number | 1780676585
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Entity Type | Organization
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Legal Business Name | RIVERSIDE NEPHROLOGY ASSOCIATES, INC.
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 929 JASONWAY AVE SUITE 4A
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City | COLUMBUS
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State | OH
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Zip | 43214-2464
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Country | US
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Telephone | 614-538-2250
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Fax | 614-538-2256
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Provider Business Mailing Address
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Address Line | 929 JASONWAY AVE
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City | COLUMBUS
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State | OH
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Zip | 43214-2464
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Country | US
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Telephone | 614-538-2250
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Fax | 614-538-2256
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. JULIE BARNES
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Credential |
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Telephone | 614-538-2250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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