Riverside Health Care Center

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

636 Issued in MT

Legal business name

RIVERSIDE HEALTH CARE CENTER

Practice address

1301 E Broadway St
Missoula, MT 59802-4905

Phone

(406) 721-0680

Fax

(406) 721-1101

NPI assigned

Dec 27, 2006

Last updated

Aug 22, 2020By 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

John Goodman, CPA

Title

Managing Partner

Phone

(952) 361-8000

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Riverside Health Care C2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Riverside Health Care Center

  dba Riverside Health & Rehabilitation

  • Skilled Nursing Facility
  • Missoula, MT
  • NPI 1356308399
  NPD tax ID

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609931641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024905",
            "telephone_number": "406-721-0680",
            "fax_number": "406-721-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE HEALTH CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "952-361-8000",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MT",
            "license": "636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2704496",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212953",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• River Montana LLC
• Kelly River
• Andrea Rivera, L.AC., LMT
• Riverbank Counseling
• Riverside Health Care Center (Riverside Health & Rehabilitation)
• Debra Kay Rivey, LCSW
• Suzy Rizza, LCPC
• RNH Medical Supply Inc
• Amy Janice Robar, LCSW
• Kristen Joan Robbins, PHARMD

• Long Term Care Pharmacy in Missoula, MT
• Providers in Missoula, MT by specialty
• Long Term Care Pharmacy in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.