northriverpca.com
Open in
urlscan Pro
50.62.89.58
Public Scan
Submitted URL: https://northriverpca.com/bill-pa
Effective URL: https://northriverpca.com/bill-pay/
Submission: On August 17 via api from US — Scanned from US
Effective URL: https://northriverpca.com/bill-pay/
Submission: On August 17 via api from US — Scanned from US
Form analysis 3 forms found in the DOM
GET /index.php
<form method="get" id="searchform" action="/index.php">
<input type="text" value="" name="s" id="s" placeholder="Search"> <input type="submit" id="searchsubmit" value="Search">
</form>POST https://hosted.transactionexpress.com/Transaction/Transaction/Index
<form action="https://hosted.transactionexpress.com/Transaction/Transaction/Index" method="POST" target="_blank">
<p><input id="HostedKey" name="HostedKey" type="hidden" value="ea44d7a9-b623-487b-9e10-c0bae8062d7e"> <input id="Gateway_ID" name="Gateway_ID" type="hidden" value="9015372849"> <input id="IndustryCode" name="IndustryCode" type="hidden" value="2">
<input id="Amount" name="Amount" type="hidden" value=""> <input id="RecurringType" name="RecurringType" type="hidden" value="N"> <input id="RecurringAmount" name="RecurringAmount" type="hidden" value=""> <input id="RURL" name="RURL" type="hidden"
value="http://7kc.191.myftpupload.com/thank-you"> <input id="CURL" name="CURL" type="hidden" value="http://7kc.191.myftpupload.com"> <input id="AVSRequired" name="AVSRequired" type="hidden" value="Y"> <input id="CVV2Required"
name="CVV2Required" type="hidden" value="Y"> <input id="EmailRequired" name="EmailRequired" type="hidden" value="Y"> <input id="PostRspMsg" name="PostRspMsg" type="hidden" value="N"></p>
<p> </p>
<p style="text-align: center;">MRN/Account #: <input id="custrefid" name="custrefid" required="" type="text" value=""><br><input id="Submit" name="Submit" type="Submit" value="Make a One-Time Payment"></p>
</form>POST https://hosted.transactionexpress.com/Transaction/Transaction/Index
<form action="https://hosted.transactionexpress.com/Transaction/Transaction/Index" method="POST" target="_blank">
<p><input id="HostedKey" name="HostedKey" type="hidden" value="ea44d7a9-b623-487b-9e10-c0bae8062d7e"> <input id="Gateway_ID" name="Gateway_ID" type="hidden" value="9015372849"> <input id="IndustryCode" name="IndustryCode" type="hidden" value="2">
<input id="Amount" name="Amount" type="hidden" value="na"> <input id="RecurringType" name="RecurringType" type="hidden" value="A"> <input id="RecurringAmount" name="RecurringAmount" type="hidden" value=""> <input id="RURL" name="RURL"
type="hidden" value="http://7kc.191.myftpupload.com/thank-you"> <input id="CURL" name="CURL" type="hidden" value="http://7kc.191.myftpupload.com"> <input id="AVSRequired" name="AVSRequired" type="hidden" value="Y"> <input id="CVV2Required"
name="CVV2Required" type="hidden" value="Y"> <input id="EmailRequired" name="EmailRequired" type="hidden" value="Y"> <input id="PostRspMsg" name="PostRspMsg" type="hidden" value="N"></p>
<p> </p>
<p>MRN/Account #: <input id="custrefid" name="custrefid" required="" type="text" value=""><br><input id="Submit" name="Submit" type="Submit" value="Set up a Recurring Payment"></p>
</form>Text Content
* News * Patient Portal * Home * Meet our Staff * Our Services * NR Wellness & Weight Loss * Pure Caps Vitamins * Appointment Info * Billing Info * Online Bill Pay * Hours & Location * Contact Us * Career * Patient Portal WELCOME TO NORTHRIVER PRIMARY CARE ASSOCIATE'S ONLINE BILL PAY CENTER! PLEASE USE ONE OF THE FOLLOWING BOXES TO MAKE A PAYMENT THE LEFT BOX IS TO MAKE A ONE-TIME PAYMENT THE RIGHT BOX IS TO SETUP A RECURRING PAYMENT ON AN ACCOUNT YOU WILL NEED YOUR MRN/ACCOUNT# (LOCATED ON YOUR INVOICE) TO ACCESS EITHER PAYMENT AREA MRN/Account #: MRN/Account #: NorthRiver Primary Care Associates 4310 Watermelon Road, Northport, Alabama 35473 Phone: (205)330-5266 | Fax: (205) 330-9915 | Email: info@northriverpca.com * Online Bill Pay * Patient Portal * HIPAA Policy * Notice of Nondiscrimination * Website by ShandyCreative.com © NorthRiver Primary Care Associates 2024. All Rights Reserved.