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NPI Code Detail

MEDICARE: WHITE RIVER RURAL HEALTH CENTER INC

MEDICARE: WHITE RIVER RURAL HEALTH CENTER INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861654006
Entity Type Code : Organization
Provider Name (Legal Business Name) : WHITE RIVER RURAL HEALTH CENTER INC
Provider Business Mailing Address
First Line : PO BOX 497
Second Line :
City : AUGUSTA
State : AR
Zip : 72006-0497
Country : US
Telephone Number : 870-237-9928
Fax Number : 870-347-3492
Provider Business Practice Location Address
First Line : 1009 HIGHWAY 18
Second Line :
City : LAKE CITY
State : AR
Zip : 72437-9622
Country : US
Telephone Number : 870-237-9928
Fax Number : 870-237-1012
Authorized Official
Title or Position : CEO
Name : DR. STEVEN F COLLIER
Credential :
Telephone Number : 870-347-2534
Provider Enumeration Date : 06/30/2008
Last Update Date : 07/07/2009

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Directions to “WHITE RIVER RURAL HEALTH CENTER INC ” Practice Location

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