RIVERSTONEMD PC NPI 1285661595

NPI Information

NPI: 1285661595
Provider Name: RIVERSTONEMD PC

Doing Business As: RIVERSTONEMD RURAL HEALTH CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
101 RIVERSTONE VIS
SUITE 205
BLUE RIDGE, GA
ZIP 30513
Phone: (706) 258-4100
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RIVERSTONEMD PC is a rural health clinic center in Blue Ridge, GA. RIVERSTONEMD PC NPI is 1285661595. The provider is registered as an organization entity type.
The provider Is Doing Business As Riverstonemd Rural Health Clinic.

The provider's business location address is:

101 RIVERSTONE VIS
SUITE 205
BLUE RIDGE, GA
ZIP 30513-648
Phone: (706) 258-4100
Fax: (706) 632-3585

The provider's authorized official is Peggy Trigg .
The authorized official title is Credentialing Manager and has the following contact phone number (706) 258-4142.

The enumeration date for this NPI number is 6/26/2006 and was last updated on 3/25/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health	032826	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	113858	MEDICARE PIN	GEORGIA
2	000621244A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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