Organization
RIVERVIEW HOSPITAL
Active
Other names
Morristown Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN MOORE M.D. (PRESIDENT/OWNER)
(812) 332-2265
Entity
Organization
Contact information
Practice address
868 SOUTH WASHINGTON ST, MORRISTOWN, IN 46161-9633
(765) 763-6012
(765) 763-7261
Mailing address
868 SOUTH WASHINGTON ST, MORRISTOWN, IN 46161-9633
(765) 763-6012
(765) 763-7261
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
050004221
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000108756
BLUE CROSS BLUE SHIELD
IN
05
—
100291030A
—
IN
Enumeration date
03/20/2006
Last updated
04/06/2017
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