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General NPI Number Information
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NPI Number | 1093607533
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Entity Type | Organization
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Legal Business Name | RIVER VALLEY PRIMARY CARE SERVICES
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Dates
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Enumeration Date | 07/18/2025
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 2074 RICE ST
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City | WALDRON
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State | AR
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Zip | 72958-7435
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Country | US
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Telephone | 479-307-8760
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Fax | 479-307-8761
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Provider Business Mailing Address
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Address Line | PO BOX 130
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City | RATCLIFF
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State | AR
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Zip | 72951-0130
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Country | US
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Telephone | 479-431-2057
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Fax |
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Authorized Official
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Title or Position | BUSINESS DEVELOPMENT
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Name | NIKKI LEANN MCKINNEY
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Credential | MBA
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Telephone | 479-431-2057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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