Provider Demographics
NPI:1699002840
Name:RIVER OAKS MANAGEMENT COMPANY, LLC
Entity Type:Organization
Organization Name:RIVER OAKS MANAGEMENT COMPANY, LLC
Other - Org Name:CAREPLUS FAMILY MEDICAL AT BRANDON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOYNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:601-825-3074
Mailing Address - Street 1:201 N COLLEGE ST
Mailing Address - Street 2:STE. 102
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042-4437
Mailing Address - Country:US
Mailing Address - Phone:601-825-3074
Mailing Address - Fax:601-825-7296
Practice Address - Street 1:201 N COLLEGE ST
Practice Address - Street 2:STE. 102
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042-4437
Practice Address - Country:US
Practice Address - Phone:601-825-3074
Practice Address - Fax:601-825-7296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSC02454Medicare PIN