Provider Demographics
NPI:1003238049
Name:RIVERVIEW HOSPITAL
Entity Type:Organization
Organization Name:RIVERVIEW HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-776-7228
Mailing Address - Street 1:2749 E COVENANTER DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-5454
Mailing Address - Country:US
Mailing Address - Phone:812-332-2265
Mailing Address - Fax:
Practice Address - Street 1:3154 S STATE ROAD 135
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-9609
Practice Address - Country:US
Practice Address - Phone:317-535-3344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-10
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201221460Medicaid
IN155821Medicare Oscar/Certification