Provider Demographics
NPI:1316473127
Name:RIVERSIDE PHARMACY SERVICES CHARLOTTESVILLE
Entity type:Organization
Organization Name:RIVERSIDE PHARMACY SERVICES CHARLOTTESVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP/CFO
Authorized Official - Prefix:
Authorized Official - First Name:W
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:757-534-7000
Mailing Address - Street 1:1335 CARLTON AVE
Mailing Address - Street 2:ATTN PHARMACY
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-5813
Mailing Address - Country:US
Mailing Address - Phone:434-529-1300
Mailing Address - Fax:
Practice Address - Street 1:1335 CARLTON AVE
Practice Address - Street 2:ATTN PHARMACY
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-5813
Practice Address - Country:US
Practice Address - Phone:434-529-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIVERSIDE HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy