MEDICARE: REGIONAL HOME CARE, 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1568455418
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGIONAL HOME CARE, INC.

Provider Business Mailing Address
First Line	:	235 W COMMERCIAL ST
Second Line	:
City	:	KAHOKA
State	:	MO
Zip	:	63445-1413
Country	:	US
Telephone Number	:	660-727-2365
Fax Number	:	660-727-2620

Provider Business Practice Location Address
First Line	:	235 W COMMERCIAL ST
Second Line	:
City	:	KAHOKA
State	:	MO
Zip	:	63445-1413
Country	:	US
Telephone Number	:	660-727-2365
Fax Number	:	660-727-2620

Authorized Official
Title or Position	:	OWNER
Name	:	JENNIFER DAWSON
Credential	:
Telephone Number	:	319-835-9035

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	08/22/2020

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