Healthcare Provider Details

I. General information

NPI: 1710929518
Provider Name (Legal Business Name): RIVER VALLEY EMERGENCY PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2609 MILITARY RD
BENTON AR
72015-2717
US

IV. Provider business mailing address

2609 MILITARY RD
BENTON AR
72015-2717
US

V. Phone/Fax

Practice location:
  • Phone: 501-315-6500
  • Fax: 501-315-0006
Mailing address:
  • Phone: 501-315-6500
  • Fax: 501-315-0006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number
License Number State

VIII. Authorized Official

Name: LINDA MCCALL
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 501-315-6500