RIVERFRONT MEDICAL


Address: 105 Woodberry Ln, Fayetteville, NY 13066-1745
Phone: 3154459655

RIVERFRONT MEDICAL (NPI# 1780922302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1780922302
Entity Type Organization
Organization Name RIVERFRONT MEDICAL
Practice Address 105 Woodberry Ln
Fayetteville
NY 13066-1745
Mailing Address 1020 7th North St
Suite 220
Liverpool
NY 13088-6192
Practice Telephone 3154459655
Mailing Telephone 3154513906
Enumeration Date 2013-01-17
Last Update Date 2013-01-17
Authorized Official Name PETER CLARK (PRESIDENT)
Authorized Official Telephone 3154513906
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QC1800X Clinic/Center
Specialization: Corporate Health
163502-1 NY Ambulatory Health Care Facilities

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities RIVERFRONT MEDICAL HOLDINGS, LLC 1173 S 250 W Ste 301, St George, UT 84770-6753

Office Location

Street Address 105 WOODBERRY LN
City FAYETTEVILLE
State NY
Zip Code 13066-1745

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Taxonomy Information

Taxonomy Code 261QC1800X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Corporate Health

Taxonomy Definition

Definition to come...

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Competitor

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City FAYETTEVILLE
Zip Code 13066

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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