Black River Healthcare, Inc.

LBN: Black River Healthcare, Inc.
Black River Healthcare, Inc. is an health care organization with primary practice located at 1879 N Westwood Blvd , Poplar Bluff MO 63901-2833. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. Black River Healthcare, Inc. can be contacted via phone (573) 727-9793, or through Gresham, Shelly Yvonne via phone (573) 727-9793.

Contact Information

Primary practice address
1879 N Westwood Blvd Poplar Bluff MO 63901-2833
Phone: (573) 727-9793
Fax: (573) 785-1854
Website:
Map and Directions
Authorized official contact:
Name: Gresham, Shelly Yvonne Family Nurse Practitioner (FNP)
Phone: (573) 727-9793

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X Missouri

Profile Details

NPI number 1376841064
LBN Legal business name Black River Healthcare, Inc.
DBA Doing business as
Authorized official Gresham, Shelly Yvonne Family Nurse Practitioner (FNP)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 4th, 2011
Last updated Jul 19th, 2011 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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