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Organization

RIVERVIEW HOSPITAL

Active
Other names
Copper Trace Health and Living, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
BRANT BUCCIARELLI (CEO)
(317) 773-0760
Entity
Organization

Contact information

Practice address
1250 W 146TH ST, CARMEL, IN 46074-9808
(317) 844-5050
Mailing address
2749 E COVENANTER DR, BLOOMINGTON, IN 47401-5454
(812) 332-2265

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201341880
IN
Enumeration date
06/26/2015
Last updated
03/09/2018
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