Organization
RIVER VALLEY PRIMARY CARE SERVICES
Active
Other names
RVPCS Northside Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME JOSEPH WHITE (EXECUTIVE DIRECTOR)
(479) 431-2057
Entity
Organization
Contact information
Practice address
4900 KELLEY HIGHWAY, FORT SMITH, AR 72904-5000
(479) 785-5700
(479) 785-5708
Mailing address
PO BOX 130, RATCLIFF, AR 72951-0130
(479) 635-5300
(479) 635-2010
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255357794
—
AR
05
—
162672749
—
AR
05
—
770106349
—
AR
Enumeration date
01/25/2007
Last updated
05/15/2023
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