Provider Demographics
NPI:1518509181
Name:RIVERVIEW HOSPITAL
Entity Type:Organization
Organization Name:RIVERVIEW HOSPITAL
Other - Org Name:RIVERVIEW HEALTH EMERGENCY ROOM & URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAYNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FRIEND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-776-7228
Mailing Address - Street 1:395 WESTFIELD RD.
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-1425
Mailing Address - Country:US
Mailing Address - Phone:317-773-0760
Mailing Address - Fax:317-770-6911
Practice Address - Street 1:9690 E 116TH ST
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-2838
Practice Address - Country:US
Practice Address - Phone:317-214-5750
Practice Address - Fax:317-214-5751
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIVERVIEW HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-15
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300030793Medicaid
IN300035674Medicaid
IN300041586Medicaid