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NPI Code Detail

MEDICARE: RIVERVIEW NURSING HOME. INC.

MEDICARE: RIVERVIEW NURSING HOME. INC.
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
1313M00000XNursing Facility/Intermediate Care Facility579RI
2314000000XSkilled Nursing Facility579RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1402008OTHERRIBLUE CHIP
2507-2OTHERRIBLUE CROSS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790783116
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVERVIEW NURSING HOME. INC.
Provider Business Mailing Address
First Line : 588 PAWTUCKET AVE
Second Line :
City : PAWTUCKET
State : RI
Zip : 02860-6057
Country : US
Telephone Number : 401-751-3800
Fax Number : 401-751-6350
Provider Business Practice Location Address
First Line : 546 MAIN ST
Second Line :
City : COVENTRY
State : RI
Zip : 02816-7852
Country : US
Telephone Number : 401-821-6837
Fax Number : 401-823-9840
Authorized Official
Title or Position : COO
Name : KELLY ARNOLD
Credential :
Telephone Number : 401-751-3800
Provider Enumeration Date : 07/10/2005
Last Update Date : 11/08/2024

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