Healthcare Provider Details

I. General information

NPI: 1609823749
Provider Name (Legal Business Name): REGIONAL HEALTH PHYSICIANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 01/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 N 10TH ST
SPEARFISH SD
57783-1530
US

IV. Provider business mailing address

1316 N 10TH ST
SPEARFISH SD
57783-1530
US

V. Phone/Fax

Practice location:
  • Phone: 605-642-3113
  • Fax: 605-642-3117
Mailing address:
  • Phone: 605-642-3113
  • Fax: 605-642-3117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number11151
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MRS. LINDA MARIE HARLAN
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 605-642-3113