Provider Demographics
NPI:1912157801
Name:RIVERVIEW REGIONAL MEDICAL CENTER , LLC
Entity Type:Organization
Organization Name:RIVERVIEW REGIONAL MEDICAL CENTER , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:MATT
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:256-543-5840
Mailing Address - Street 1:600 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5304
Mailing Address - Country:US
Mailing Address - Phone:256-543-5840
Mailing Address - Fax:256-543-5554
Practice Address - Street 1:600 S 3RD ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5304
Practice Address - Country:US
Practice Address - Phone:256-543-5840
Practice Address - Fax:256-543-5554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALH2803282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALHOS0046HMedicaid