MEDICARE: RIVERTOWN CAPITAL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174222756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERTOWN CAPITAL INC

Provider Business Mailing Address
First Line	:	2013 HIGHWAY 280 BYP
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-3624
Country	:	US
Telephone Number	:	706-289-7546
Fax Number	:

Provider Business Practice Location Address
First Line	:	2013 HIGHWAY 280 BYP
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-3687
Country	:	US
Telephone Number	:	706-289-7546
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. GRADY W STONE
Credential	:	LDO
Telephone Number	:	334-480-4015

Provider Enumeration Date	:	03/02/2023
Last Update Date	:	03/11/2026

Similar Medicare Providers

1033119557 — BARBARA JEAN SMITH MSN, RN, FNP-BC,CDE
Practice Location Address:

1004 N HIGHWAY 92 , SUITE C
JEFFERSON CITY, TN
37760-3687

Practice Phone: 865-475-6100
Practice Fax: 865-475-6106

1902867567 — DR. HEATHER S ZAWAHRY M.D.
Practice Location Address:

2101 NORTHSIDE DR UNIT 501
PANAMA CITY, FL
32405-3687

Practice Phone: 850-785-3464
Practice Fax: 850-785-2791

1104888106 — ISABEL MARIA PARRIS-RAMIE D.O.
Practice Location Address:

2101 NORTHSIDE DR UNIT 702
PANAMA CITY, FL
32405-3687

Practice Phone: 850-785-0040
Practice Fax: 850-785-5717

1871516682 — GLENDA F WILSON PT
Practice Location Address:

2101 NORTHSIDE DR UNIT 502
PANAMA CITY, FL
32405-3687

Practice Phone: 850-913-7040
Practice Fax: 850-913-0290

1366584807 — MS. LYNDA MARIE MORELLI APRN
Practice Location Address:

1004 N HIGHWAY 92 , SUITE C
JEFFERSON CITY, TN
37760-3687

Practice Phone: 865-475-2120
Practice Fax: 855-544-2120

1346364312 — MS. RIANNE ISABEL CHAVEZ-HANSEN LMT, LMP
Practice Location Address:

2101 NORTHSIDE DR UNIT 402
PANAMA CITY, FL
32405-3687

Practice Phone: 850-867-3795
Practice Fax: 850-215-8398

Directions to “RIVERTOWN CAPITAL INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.