Healthcare Provider Details

I. General information

NPI: 1831177427
Provider Name (Legal Business Name): RIVERVIEW HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 02/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601A WESTFIELD RD
NOBLESVILLE IN
46060-1323
US

IV. Provider business mailing address

395 WESTFIELD RD
NOBLESVILLE IN
46060-1425
US

V. Phone/Fax

Practice location:
  • Phone: 317-776-1071
  • Fax: 317-776-1072
Mailing address:
  • Phone: 317-776-7108
  • Fax: 317-776-7134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number05-005054-1
License Number StateIN

VIII. Authorized Official

Name: MS. PATRICIA K FOX
Title or Position: PRESIDENT & CEO
Credential: MBA
Phone: 317-776-7108