Provider Demographics
NPI:1952738981
Name:RIVER CITY PRIMARY & URGENT CARE
Entity Type:Organization
Organization Name:RIVER CITY PRIMARY & URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VIPUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-487-8320
Mailing Address - Street 1:6947 MERRILL RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-2684
Mailing Address - Country:US
Mailing Address - Phone:904-743-2222
Mailing Address - Fax:904-743-3087
Practice Address - Street 1:904 PARK AVE
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4120
Practice Address - Country:US
Practice Address - Phone:904-435-0799
Practice Address - Fax:904-435-0797
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIVER CITY MEDICAL ASSOCIATES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-04
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME121788207Q00000X, 207R00000X, 261QP2300X, 261QU0200X
207R00000X, 208D00000X
FLME57227261QP2300X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care