Healthcare Provider Details

I. General information

NPI: 1700175429
Provider Name (Legal Business Name): REGIONAL HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 04/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 STATE ST STE 100
ERIE PA
16507-1463
US

IV. Provider business mailing address

717 STATE ST STE 16
ERIE PA
16501-1360
US

V. Phone/Fax

Practice location:
  • Phone: 814-456-8105
  • Fax: 814-456-8126
Mailing address:
  • Phone: 814-877-7100
  • Fax: 814-877-2939

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