Individual ProviderRussell RiderAnesthesiologyAllopathic & Osteopathic PhysiciansPractice Address104 West 5th Ave, Suite 230e, Spokane, WA 99204-2483(509) 838-8561(509) 838-8828PECOS EnrollmentBased on the most recent information from CMS, provider Russell Rider is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1093728321Provider TypeIndividualFull NameRider, RussellTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date8/15/2006Last Updated8/15/2008Contact InformationPractice LocationPractice Address104 West 5th Ave, Suite 230e, Spokane, WA 99204-2483Phone(509) 838-8561Fax(509) 835-4058Mailing LocationMailing Address104 West 5th Ave, Suite 230e, Spokane, WA 99204-2483Phone(509) 838-8828Fax(509) 835-4058Provider TaxonomiesCodeDescriptionLicenseCode207L00000XPrimaryDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicense29211WashingtonProvider IdentifiersIDDescriptionIssuerID8150245DescriptionMedicaidIssuerUnlistedWashington