1710114293 NPI number — RIVERVIEW SURGERY CENTER AT THE NAVY YARD LP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710114293 NPI number — RIVERVIEW SURGERY CENTER AT THE NAVY YARD LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RIVERVIEW SURGERY CENTER AT THE NAVY YARD LP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710114293
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
THREE CRESCENT DRIVE
Provider Second Line Business Mailing Address:
NAVY YARD CORPORATE CENTER
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
267-419-3600
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
THREE CRESCENT DRIVE
Provider Second Line Business Practice Location Address:
NAVY YARD CORPORATE CENTER
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
267-419-3600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/11/2009

Additional Information

Authorized Official

Authorized Official Last Name:
TASSET
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
R
Authorized Official Title or Position:
VICE CHAIR, NUEHEALTH
Authorized Official Telephone Number:
913-647-6475

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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