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NPI Code Detail

MEDICARE: RIVERVIEW CARE CENTER, LLC

MEDICARE: RIVERVIEW CARE CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility03-051MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
168720701OTHERBLUE CROSS

General Provider Information

NPI Number : 1528021698
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVERVIEW CARE CENTER, LLC
Provider Business Mailing Address
First Line : 4 IVYBROOK BLVD
Second Line :
City : IVYLAND
State : PA
Zip : 18974-1700
Country : US
Telephone Number : 215-357-6055
Fax Number : 215-357-6968
Provider Business Practice Location Address
First Line : 1 EASTERN BLVD
Second Line :
City : ESSEX
State : MD
Zip : 21221-7016
Country : US
Telephone Number : 215-357-6055
Fax Number : 215-357-6968
Authorized Official
Title or Position : PRESIDENT
Name : ALLEN SEGAL
Credential :
Telephone Number : 215-357-6055
Provider Enumeration Date : 04/10/2006
Last Update Date : 07/21/2022

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Directions to “RIVERVIEW CARE CENTER, LLC ” Practice Location

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