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RIVER VALLEY PRIMARY CARE SERVICES NPI 1023163193


NPI Information

NPI: 1023163193
Provider Name: RIVER VALLEY PRIMARY CARE SERVICES

Doing Business As: RVPCS NORTHSIDE CLINIC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 04D1062378

Address:
4900 KELLEY HIGHWAY
FORT SMITH, AR
ZIP 72904
Phone: (479) 785-5700
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RIVER VALLEY PRIMARY CARE SERVICES is a federally qualified health center (fqhc) clinic center in Fort Smith, AR. RIVER VALLEY PRIMARY CARE SERVICES NPI is 1023163193. The provider is registered as an organization entity type.
The provider Is Doing Business As Rvpcs Northside Clinic.

The provider's business location address is:

4900 KELLEY HIGHWAY
FORT SMITH, AR
ZIP 72904-000
Phone: (479) 785-5700
Fax: (479) 785-5708

The provider's authorized official is Jerome Joseph White .
The authorized official title is Executive Director and has the following contact phone number (479) 431-2057.

The CLIA number assigned to this NPI record is 04D1062378 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/25/2007 and was last updated on 5/15/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1770106349MEDICAIDARKANSAS
21255357794MEDICAIDARKANSAS
3162672749MEDICAIDARKANSAS

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: 4/28/2024

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.