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General NPI Number Information
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NPI Number | 1861779852
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Entity Type | Organization
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Legal Business Name | RIVERSIDE REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 11/04/2011
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Last Update Date | 11/04/2011
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Provider Practice Location Address
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Address Line | 542 K ELEANOR COURT
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City | NEWPORT NEWS
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State | VA
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Zip | 23602
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Country | US
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Telephone | 757-358-0042
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Fax |
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Provider Business Mailing Address
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Address Line | 542 ELEANOR CT APT K
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-4339
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Country | US
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Telephone | 757-358-0042
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Fax |
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Authorized Official
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Title or Position | NURSE MANAGER
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Name | SUSAN DONSTON
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Credential | MRS
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Telephone | 757-594-2783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 733373
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 0001215093
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License Number State | VA
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