Riverside Cytology Laboratory, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

15D1022101 Issued in IN

Legal business name

RIVERSIDE CYTOLOGY LABORATORY, INC

Practice address

516 Main St
Suite B
Tell City, IN 47586-2211

Phone

(812) 548-0521

Fax

(812) 548-0521

NPI assigned

Jan 19, 2007

Last updated

Nov 10, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eric J Daum

Title

President

Phone

(812) 548-0521

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320883200000",
    "number": "1093868432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 MAIN ST",
            "address_2": "SUITE B",
            "city": "TELL CITY",
            "state": "IN",
            "postal_code": "475862211",
            "telephone_number": "812-548-0521",
            "fax_number": "812-548-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 MAIN ST",
            "address_2": "SUITE B",
            "city": "TELL CITY",
            "state": "IN",
            "postal_code": "475862211",
            "telephone_number": "812-548-0521",
            "fax_number": "812-548-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE CYTOLOGY LABORATORY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2011-11-10",
        "status": "A",
        "authorized_official_last_name": "DAUM",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-548-0521"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IN",
            "license": "15D1022101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200469070A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "000000383611",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37000759",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sidney Ann Raetz, FNP-C
• Amanda Rae Ramsey
• Don A Ray, CRNA
• Deborah A Reed, P.T.
• Kassandra Leigh Risse, BCBA
• Terissa Roark
• Jane L. Roberts, CRNA
• James Richard Rogan II, MD
• Donald A. Rothrauff, DPM
• Sarah Rudkosky, NP

• Clinical Medical Laboratory in Tell City, IN
• Providers in Tell City, IN by specialty
• Clinical Medical Laboratory in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.