Provider Demographics
NPI:1477031920
Name:R-HEALTH PRIMARY CARE MEDICAL HOME KC
Entity Type:Organization
Organization Name:R-HEALTH PRIMARY CARE MEDICAL HOME KC
Other - Org Name:RPCMH RIVER MARKET
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-600-4590
Mailing Address - Street 1:210 YORKTOWN PLZ
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1424
Mailing Address - Country:US
Mailing Address - Phone:215-600-4590
Mailing Address - Fax:
Practice Address - Street 1:531 GRAND BLVD STE 1
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64106-1779
Practice Address - Country:US
Practice Address - Phone:215-600-4590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:R-HEALTH PRIMARY CARE MEDICAL HOME KC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-06
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care