Healthcare Provider Details

I. General information

NPI: 1790043693
Provider Name (Legal Business Name): RIVER VIEW URGENT CARE & MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2012
Last Update Date: 09/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

382 N OVERLAND AVE
BURLEY ID
83318-3433
US

IV. Provider business mailing address

PO BOX 820
BURLEY ID
83318-0820
US

V. Phone/Fax

Practice location:
  • Phone: 208-678-6996
  • Fax: 208-678-6866
Mailing address:
  • Phone: 208-678-6996
  • Fax: 208-678-6866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateID

VIII. Authorized Official

Name: KYLE D JAMES
Title or Position: BUSINESS MANAGER
Credential:
Phone: 208-678-6996