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NPI Code Detail

MEDICARE: REGIONAL HEALTH PHYSICIANS, INC.

MEDICARE: REGIONAL HEALTH PHYSICIANS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR1300XRural Health Clinic/Center

General Provider Information

NPI Number : 1164855813
Entity Type Code : Organization
Provider Name (Legal Business Name) : REGIONAL HEALTH PHYSICIANS, INC.
Provider Business Mailing Address
First Line : 353 FAIRMONT BLVD
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-7375
Country : US
Telephone Number : 605-755-9142
Fax Number : 605-755-9140
Provider Business Practice Location Address
First Line : 1121 WASHINGTON BLVD
Second Line :
City : NEWCASTLE
State : WY
Zip : 82701-2968
Country : US
Telephone Number : 307-746-3582
Fax Number :
Authorized Official
Title or Position : INTERIM CEO
Name : MR. JOHN Y PIERCE
Credential :
Telephone Number : 605-755-9042
Provider Enumeration Date : 08/16/2013
Last Update Date : 04/30/2014

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