Healthcare Provider Details

I. General information

NPI: 1275729402
Provider Name (Legal Business Name): RIVERVIEW HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2007
Last Update Date: 06/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 MEDICAL DR
CARMEL IN
46032-2923
US

IV. Provider business mailing address

118 MEDICAL DR
CARMEL IN
46032-2923
US

V. Phone/Fax

Practice location:
  • Phone: 317-884-4211
  • Fax: 317-846-0163
Mailing address:
  • Phone: 317-884-4211
  • Fax: 317-846-0163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number07-000095-1
License Number StateIN

VIII. Authorized Official

Name: KENT RODGERS
Title or Position: CFO
Credential:
Phone: 812-961-1881