Riverbend Healthcare Pllc - Medicare Primary Care in Vicksburg, MS

Riverbend Healthcare Pllc is a medicare enrolled primary clinic (Clinic/center) in Vicksburg, Mississippi. The current practice location for Riverbend Healthcare Pllc is 2011 Hwy 61 N, Vicksburg, Mississippi. For appointments, you can reach them via phone at (601) 456-2277. The mailing address for Riverbend Healthcare Pllc is Po Box 29841, Belfast, Maine and phone number is (601) 456-2277.

Riverbend Healthcare Pllc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1417620071. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (601) 456-2277.

Contact Information

Riverbend Healthcare Pllc
2011 Hwy 61 N
Vicksburg
MS 39183
(601) 456-2277
Not Available

Primary Care Clinic Profile

Full NameRiverbend Healthcare Pllc
SpecialityClinic/Center
Location2011 Hwy 61 N, Vicksburg, Mississippi
Authorized Official Name and PositionManivanh A Prudhomme (CEO)
Authorized Official Contact6014562277
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Riverbend Healthcare Pllc
Po Box 29841
Belfast
ME 04915-2050

Ph: (601) 456-2277
Riverbend Healthcare Pllc
2011 Hwy 61 N
Vicksburg
MS 39183

Ph: (601) 456-2277

NPI Details:

NPI Number1417620071
Provider Enumeration Date07/29/2021
Last Update Date01/17/2023

Medicare PECOS Information:

Medicare PECOS PAC ID4688071335
Medicare Enrollment IDO20210922001433

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Medical Identifiers

Medical identifiers for Riverbend Healthcare Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1417620071NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261Q00000XClinic/center (* (Not Available))Primary
363LF0000XNurse Practitioner - Family (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Riverbend Healthcare Pllc acts as a billing entity for following providers:
Provider NameManivanh A Prudhomme
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144831140
PECOS PAC ID: 0648690842
Enrollment ID: I20201008002132

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