Provider Demographics
NPI:1932839537
Name:RIVERVIEW PHARMACIES INC
Entity Type:Organization
Organization Name:RIVERVIEW PHARMACIES INC
Other - Org Name:RIVERVIEW PHARMACY LTC/RIVERVIEW PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT
Authorized Official - Phone:815-933-1735
Mailing Address - Street 1:475 BROWN BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-2325
Mailing Address - Country:US
Mailing Address - Phone:815-933-1735
Mailing Address - Fax:815-933-3370
Practice Address - Street 1:475 BROWN BLVD STE 105
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-2325
Practice Address - Country:US
Practice Address - Phone:815-933-1735
Practice Address - Fax:815-933-3370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy