Organization
RIVER VALLEY PRIMARY CARE SERVICES
Active
Other names
Mulberry Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME WHITE (C.E.O.)
(479) 431-2057
Entity
Organization
Contact information
Practice address
421 N. MAIN STREET, MULBERRY, AR 72947
(479) 997-1484
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
—
180401749
—
AR
05
—
771108449
—
AR
Enumeration date
08/28/2009
Last updated
03/08/2022
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