| Organization Name: | FOUR RIVERS HOME HEALTH CARE INC |
| NPI Number: | 1275513913 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBIN L MENCHEN (CHIEF ADMINISTRATION OFFICER) |
| Mailing Address: | 20 E Springfield Rd Sullivan |
| State: | MO US |
| Postal Code: | 630801310 |
| Phone Number: | 5734686688 |
| Fax Number: | 5738602120 |
| NPI Enumeration Date: | 01/19/2006 |
| NPI Last Update Date: | 07/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |