Healthcare Provider Details

I. General information

NPI: 1548371685
Provider Name (Legal Business Name): REGIONAL MEDICAL CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 MONROE ST
DOVER OH
44622-2046
US

IV. Provider business mailing address

603 MONROE ST
DOVER OH
44622-2046
US

V. Phone/Fax

Practice location:
  • Phone: 330-364-8889
  • Fax:
Mailing address:
  • Phone: 330-364-8889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number61813
License Number StateOH

VIII. Authorized Official

Name: DR. JAMES DAVID MOORE
Title or Position: DR/OWNER
Credential: M.D.
Phone: 330-364-8889