Healthcare Provider Details

I. General information

NPI: 1114789591
Provider Name (Legal Business Name): RIVERVIEW ASC PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2024
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7633 E JEFFERSON AVE STE 330
DETROIT MI
48214-3732
US

IV. Provider business mailing address

1 PARKWAY NORTH BLVD STE 200S
DEERFIELD IL
60015-2534
US

V. Phone/Fax

Practice location:
  • Phone: 313-823-5338
  • Fax: 313-823-5950
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JASON LOHMEYER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 847-949-3855