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NPI 1831999010

NPI 1831999010 : RIVER CITY SURGICAL, PLLC : MIDLOTHIAN, VA

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General NPI Number Information
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    NPI Number           |    1831999010
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    Entity Type          |    Organization 
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    Legal Business Name  |    RIVER CITY SURGICAL, PLLC 
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Dates
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    Enumeration Date     |    03/17/2025
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    Last Update Date     |    09/07/2025
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Provider Practice Location Address
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    Address Line         |    13710 ST FRANCIS BLVD 
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    City                 |    MIDLOTHIAN
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    State                |    VA
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    Zip                  |    23114-3267
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    Country              |    US
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    Telephone            |    804-999-4354
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1021 HIOAKS RD UNIT 8855 
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    City                 |    RICHMOND
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    State                |    VA
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    Zip                  |    23225-0921
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    Country              |    US
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    Telephone            |    804-999-4354
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    Fax                  |    804-965-0037
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     TY  SCRIVENS 
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    Credential           |    LSA
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    Telephone            |    804-994-4354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    246ZC0007X
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    Taxonomy Name        |    Surgical Assistant
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    License Number       |    
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    License Number State |    
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