Organization
RIVER VALLEY PRIMARY CARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY WHITE (EXECUTIVE DIRECTOR)
(479) 635-5300
Entity
Organization
Contact information
Practice address
9755 W STATE HIGHWAY 22, RATCLIFF, AR 72951-9000
(479) 635-5300
(479) 635-2010
Mailing address
PO BOX 130, RATCLIFF, AR 72951-0130
(479) 635-5300
(479) 635-2010
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156152631
—
AR
Enumeration date
06/02/2008
Last updated
06/02/2008
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