| River Valley Primary Care Services | |
|
9755 W State Highway 22 Ratcliff AR 72951 | |
| (479) 431-2050 | |
| Not Available |
| Full Name | River Valley Primary Care Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 9755 W State Highway 22, Ratcliff, Arkansas |
| Authorized Official Name and Position | Jerome Joseph White (CEO) |
| Authorized Official Contact | 4794312057 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| River Valley Primary Care Services 9755 W State Highway 22 P.o. Box 130 Ratcliff AR 72951-9000 Ph: (479) 635-5300 | River Valley Primary Care Services 9755 W State Highway 22 Ratcliff AR 72951 Ph: (479) 431-2050 |
| NPI Number | 1952349003 |
|---|---|
| Provider Enumeration Date | 06/02/2006 |
| Last Update Date | 06/11/2019 |
| Medicare PECOS PAC ID | 0042274276 |
|---|---|
| Medicare Enrollment ID | O20041117000112 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952349003 | NPI | - | NPPES |
| 156152631 | Medicaid | AR | |
| 770106649 | Medicaid | AR | |
| 156966749 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
River Valley Primary Care Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9755 W State Highway 22, Ratcliff, AR 72951 Phone: 479-635-5300 Fax: 479-635-4700 |