| Riverside Health, Llc | |
|
4112 Riverside Dr Huntington WV 25705-1746 | |
| (681) 204-5535 | |
| (681) 204-5435 |
| Full Name | Riverside Health, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4112 Riverside Dr, Huntington, West Virginia |
| Authorized Official Name and Position | Abigail Lynn Richardson (OWNER) |
| Authorized Official Contact | 6812045535 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside Health, Llc 2005 Hilton Ave Ashland KY 41101-2814 Ph: (681) 204-5535 | Riverside Health, Llc 4112 Riverside Dr Huntington WV 25705-1746 Ph: (681) 204-5535 |
| NPI Number | 1174302947 |
|---|---|
| Provider Enumeration Date | 09/21/2023 |
| Last Update Date | 09/21/2023 |
| Medicare PECOS PAC ID | 4880039577 |
|---|---|
| Medicare Enrollment ID | O20240304003924 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174302947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Abigail Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124648670 PECOS PAC ID: 6204267131 Enrollment ID: I20200511000162 |
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