MEDICARE: REGIONS HOSPITAL

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
1	291U00000X	Clinical Medical Laboratory
2	282N00000X	General Acute Care Hospital	331071	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	30250	OTHER	MN	HEALTHPARTNERS SURGERY

General Provider Information

NPI Number	:	1306873872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGIONS HOSPITAL

Provider Business Mailing Address
First Line	:	PO BOX 772739
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48277-2739
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 PHALEN BLVD
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55130-5302
Country	:	US
Telephone Number	:	651-254-3908
Fax Number	:	651-254-5649

Authorized Official
Title or Position	:	VICE PRESIDENT, FINANCE
Name	:	JOHN CLARK
Credential	:
Telephone Number	:	651-254-0900

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	12/08/2025

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Directions to “REGIONS HOSPITAL ” Practice Location

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