| River Medical Healthcare Llc | |
|
2119 Highway 82 E Greenville MS 38703-6010 | |
| (662) 390-8992 | |
| Not Available |
| Full Name | River Medical Healthcare Llc |
|---|---|
| Speciality | General Practice |
| Location | 2119 Highway 82 E, Greenville, Mississippi |
| Authorized Official Name and Position | John L Herzog (PRESIDENT) |
| Authorized Official Contact | 6623350183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| River Medical Healthcare Llc Po Box 5368 Greenville MS 38704-5368 Ph: (662) 390-8992 | River Medical Healthcare Llc 2119 Highway 82 E Greenville MS 38703-6010 Ph: (662) 390-8992 |
| NPI Number | 1669957031 |
|---|---|
| Provider Enumeration Date | 10/01/2018 |
| Last Update Date | 05/20/2021 |
| Medicare PECOS PAC ID | 4981022092 |
|---|---|
| Medicare Enrollment ID | O20200922000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669957031 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Jenny C Kurts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821153388 PECOS PAC ID: 5294818779 Enrollment ID: I20080206000492 |
| Provider Name | Nisha Bhakta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669015764 PECOS PAC ID: 7810399748 Enrollment ID: I20210714001570 |
| Provider Name | Kristin Delahoussaye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912612466 PECOS PAC ID: 5193197093 Enrollment ID: I20230201003500 |
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