MEDICARE: RIVERVIEW HOSPITAL

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
1	314000000X	Skilled Nursing Facility	050002201	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831164995
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERVIEW HOSPITAL

Provider Business Mailing Address
First Line	:	3249 E COVENANTER DR
Second Line	:
City	:	BLOOMINGTON
State	:	IN
Zip	:	47401-5479
Country	:	US
Telephone Number	:	812-332-2265
Fax Number	:	823-334-0853

Provider Business Practice Location Address
First Line	:	1380 E COUNTY LINE RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-0962
Country	:	US
Telephone Number	:	317-885-7050
Fax Number	:	317-885-1022

Authorized Official
Title or Position	:	CFO
Name	:	BRANT BUCCIARELLI
Credential	:
Telephone Number	:	317-773-0760

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	05/01/2018

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Directions to “RIVERVIEW HOSPITAL ” Practice Location

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