# RIVERVIEW SURGERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669748125
- **Authorized official:** DR. SHANE DAVID BOLES MD (MD)
- **Authorized official phone:** (812) 644-2500

## Contact information

- **Practice address:** 1276 N PLAZA DR, ROCKPORT, IN 47635
- **Practice address phone:** (812) 649-2500
- **Practice address fax:** (812) 649-9427
- **Mailing address:** 1276 N PLAZA DRIVE, ROCKPORT, IN 47635
- **Mailing address phone:** (812) 649-2500
- **Mailing address fax:** (812) 649-9427

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/29/2012
- **Last updated:** 02/05/2014