MEDICARE: RILEY THERON DUBOSE

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	146L00000X	Paramedic	1800125	AL

General Provider Information

NPI Number	:	1669314514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RILEY THERON DUBOSE

Provider Business Mailing Address
First Line	:	300 CAMELLIA DR
Second Line	:
City	:	ANDALUSIA
State	:	AL
Zip	:	36420-3537
Country	:	US
Telephone Number	:	334-892-4352
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 CAMELLIA DR
Second Line	:
City	:	ANDALUSIA
State	:	AL
Zip	:	36420-3537
Country	:	US
Telephone Number	:	334-892-4352
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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Directions to “ RILEY THERON DUBOSE ” Practice Location

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