MEDICARE: REGIONAL HEALTH SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1184881575
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGIONAL HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	717 STATE STREET
Second Line	:	SUITE 16 LL
City	:	ERIE
State	:	PA
Zip	:	16501-1360
Country	:	US
Telephone Number	:	814-480-7100
Fax Number	:	814-480-7604

Provider Business Practice Location Address
First Line	:	991 ROUTE 19
Second Line	:	SUITE B
City	:	WATERFORD
State	:	PA
Zip	:	16441-9739
Country	:	US
Telephone Number	:	814-796-2553
Fax Number	:	814-796-4238

Authorized Official
Title or Position	:	PRESIDENT
Name	:	V JAMES FIORENZO
Credential	:
Telephone Number	:	814-877-6588

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	05/22/2008

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