Healthcare Provider Details

I. General information

NPI: 1740662790
Provider Name (Legal Business Name): RIVERVIEW HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2015
Last Update Date: 03/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 W 146TH ST
CARMEL IN
46074-9808
US

IV. Provider business mailing address

2749 E COVENANTER DR
BLOOMINGTON IN
47401-5454
US

V. Phone/Fax

Practice location:
  • Phone: 317-844-5050
  • Fax:
Mailing address:
  • Phone: 812-332-2265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: BRANT BUCCIARELLI
Title or Position: CEO
Credential:
Phone: 317-773-0760