Organization
RIVER VALLEY PRIMARY CARE SERVICES
Active
Other names
Northside Clinic at 6th Street
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY J. WHITE (EXECUTIVE DIRECTOR)
(479) 431-2057
Entity
Organization
Contact information
Practice address
3202 N 6TH ST, FORT SMITH, AR 72904-4164
(479) 783-3900
(479) 783-3905
Mailing address
PO BOX 130, RATCLIFF, AR 72951-0130
(479) 635-0091
(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
—
176996749
—
AR
Enumeration date
01/08/2008
Last updated
06/08/2020
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