MEDICARE: REGIS HEALTHCARE 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	333600000X	Pharmacy
2	3336L0003X	Long Term Care Pharmacy	P07501	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2177179	OTHER		PK

General Provider Information

NPI Number	:	1669969028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGIS HEALTHCARE INC.

Provider Business Mailing Address
First Line	:	2208 FORT CAMPBELL BLVD
Second Line	:
City	:	HOPKINSVILLE
State	:	KY
Zip	:	42240-4665
Country	:	US
Telephone Number	:	270-885-5515
Fax Number	:	270-885-5591

Provider Business Practice Location Address
First Line	:	2208 FORT CAMPBELL BLVD
Second Line	:
City	:	HOPKINSVILLE
State	:	KY
Zip	:	42240-4665
Country	:	US
Telephone Number	:	270-885-5515
Fax Number	:	270-885-5591

Authorized Official
Title or Position	:	OWNER
Name	:	REED GINN
Credential	:
Telephone Number	:	270-885-5515

Provider Enumeration Date	:	04/20/2018
Last Update Date	:	09/19/2025

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Directions to “REGIS HEALTHCARE INC. ” Practice Location

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