# GREAT RIVER MEDICAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GREAT RIVER MEDICAL CENTER LLC
- **Other names:** Great River Family Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1477471019
- **Legal business name:** GREAT RIVER MEDICAL CENTER LLC
- **Authorized official:** LACEY CARTER (CEO)
- **Authorized official phone:** (870) 838-7460

## Contact information

- **Practice address:** 1522 N DIVISION ST, BLYTHEVILLE, AR 72315-1448
- **Practice address phone:** (870) 838-7530
- **Mailing address:** PO BOX 108, BLYTHEVILLE, AR 72316-0108
- **Mailing address phone:** (870) 838-7530

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/09/2026
- **Last updated:** 07/09/2026