| Organization Name: | RIVERSIDE EYE CENTER PC |
| NPI Number: | 1174748081 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEVIN HANTON (IT MANAGER) |
| Mailing Address: | 4050 River Rd East China |
| State: | MI US |
| Postal Code: | 480542908 |
| Phone Number: | 8103299045 |
| Fax Number: | 8103298732 |
| NPI Enumeration Date: | 04/16/2007 |
| NPI Last Update Date: | 08/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 1146090001 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |