Healthcare Provider Details

I. General information

NPI: 1295961316
Provider Name (Legal Business Name): REGIONAL HEALTH PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2009
Last Update Date: 08/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 FLORMANN STREET
RAPID CITY SD
57701-4600
US

IV. Provider business mailing address

PO BOX 3450
RAPID CITY SD
57709-3450
US

V. Phone/Fax

Practice location:
  • Phone: 605-719-7649
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateSD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier9164420
Identifier TypeMEDICAID
Identifier StateSD
Identifier Issuer

VIII. Authorized Official

Name: JOHN Y PIERCE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 605-716-8394