Provider Demographics
NPI:1831177427
Name:RIVERVIEW HOSPITAL
Entity type:Organization
Organization Name:RIVERVIEW HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:317-776-7108
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:317-776-7108
Mailing Address - Fax:317-776-7134
Practice Address - Street 1:601A WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1323
Practice Address - Country:US
Practice Address - Phone:317-776-1071
Practice Address - Fax:317-776-1072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-04
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05-005054-1261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000081503OtherBLUE CROSS
IN100127080AMedicaid
IN100127080AMedicaid