Provider Demographics
NPI:1790718898
Name:RIVER CITY CONVENIENT CARE
Entity Type:Organization
Organization Name:RIVER CITY CONVENIENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RENA
Authorized Official - Middle Name:DELL
Authorized Official - Last Name:SALYER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:731-925-1911
Mailing Address - Street 1:1960 PICKWICK ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TN
Mailing Address - Zip Code:38372-5309
Mailing Address - Country:US
Mailing Address - Phone:731-925-1911
Mailing Address - Fax:731-925-1912
Practice Address - Street 1:1960 PICKWICK ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:TN
Practice Address - Zip Code:38372-5309
Practice Address - Country:US
Practice Address - Phone:731-925-1911
Practice Address - Fax:731-925-1912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1611208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty