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RIVER VALLEY PRIMARY CARE SERVICES INC. NPI 1639302896


NPI Information

NPI: 1639302896
Provider Name: RIVER VALLEY PRIMARY CARE SERVICES, INC.

Doing Business As: MOUNTAINBURG FAMILY CLINIC

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
#4 HIGHWAY 71 NE
MOUNTAINBURG, AR
ZIP 72946
Phone: (479) 369-2091
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RIVER VALLEY PRIMARY CARE SERVICES, INC. is a federally qualified health center (fqhc) clinic center in Mountainburg, AR. RIVER VALLEY PRIMARY CARE SERVICES, INC. NPI is 1639302896. The provider is registered as an organization entity type.
The provider Is Doing Business As Mountainburg Family Clinic.

The provider's business location address is:

#4 HIGHWAY 71 NE
MOUNTAINBURG, AR
ZIP 72946-000
Phone: (479) 369-2091
Fax: (479) 369-4119

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

The enumeration date for this NPI number is 9/3/2009 and was last updated on 2/20/2019.


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
1771108349MEDICAIDARKANSAS
2180402749MEDICAIDARKANSAS

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: 11/14/2023

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