Healthcare Provider Details

I. General information

NPI: 1124285531
Provider Name (Legal Business Name): REGIONAL HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 08/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 PEACH STREET SUITE 106
ERIE PA
16508-2769
US

IV. Provider business mailing address

717 STATE STREET SUITE 16 LL
ERIE PA
16501-1360
US

V. Phone/Fax

Practice location:
  • Phone: 814-877-5500
  • Fax: 814-877-5508
Mailing address:
  • Phone: 814-480-7100
  • Fax: 814-480-7604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: JASON ROEBACK
Title or Position: PRESIDENT
Credential:
Phone: 814-877-4242