Provider Demographics
NPI:1821488123
Name:RIVER PARK HOSPITAL LLC
Entity Type:Organization
Organization Name:RIVER PARK HOSPITAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:WIECHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-764-3000
Mailing Address - Street 1:1559 SPARTA ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-1316
Mailing Address - Country:US
Mailing Address - Phone:931-815-4000
Mailing Address - Fax:931-815-4710
Practice Address - Street 1:1559 SPARTA ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-1316
Practice Address - Country:US
Practice Address - Phone:931-815-4000
Practice Address - Fax:931-815-4710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit