Healthcare Provider Details

I. General information

NPI: 1134157092
Provider Name (Legal Business Name): REGIONS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 PHALEN BLVD
SAINT PAUL MN
55130-5302
US

IV. Provider business mailing address

PO BOX 772739 MAILSTOP 11602C
DETROIT MI
48277
US

V. Phone/Fax

Practice location:
  • Phone: 651-254-3908
  • Fax: 651-254-5649
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN M CLARK
Title or Position: VP FINANCIAL
Credential:
Phone: 651-254-0900