Organization
RIVER VALLEY PRIMARY CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEROME JOSEPH WHITE (CEO)
(479) 431-2057
Entity
Organization
Contact information
Practice address
9755 W STATE HIGHWAY 22, RATCLIFF, AR 72951
(479) 431-2050
Mailing address
9755 W STATE HIGHWAY 22, P.O. BOX 130, RATCLIFF, AR 72951-9000
(479) 635-5300
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156152631
—
AR
05
—
156966749
—
AR
05
—
770106649
—
AR
Enumeration date
06/02/2006
Last updated
06/11/2019
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