BLACK RIVER HEALTHCARE INC. NPI 1376841064

NPI Information

NPI: 1376841064
Provider Name: BLACK RIVER HEALTHCARE, INC.
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
1879 N WESTWOOD BLVD
POPLAR BLUFF, MO
ZIP 63901
Phone: (573) 727-9793
Get Directions

BLACK RIVER HEALTHCARE, INC. is a rural health clinic center in Poplar Bluff, MO. BLACK RIVER HEALTHCARE, INC. NPI is 1376841064. The provider is registered as an organization entity type.

The provider's business location address is:

1879 N WESTWOOD BLVD
POPLAR BLUFF, MO
ZIP 63901-833
Phone: (573) 727-9793
Fax: (573) 785-1854

The provider's authorized official is Shelly Yvonne Gresham .
The authorized official title is Family Nurse Practitioner and has the following contact phone number (573) 727-9793.

The enumeration date for this NPI number is 3/4/2011 and was last updated on 7/19/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health		MISSOURI	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »