MEDICARE: REGIONAL HEALTH

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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1861876278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGIONAL HEALTH

Provider Business Mailing Address
First Line	:	23756 ARENA DR
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-7302
Country	:	US
Telephone Number	:	701-213-9032
Fax Number	:

Provider Business Practice Location Address
First Line	:	2116 JACKSON BLVD
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-3495
Country	:	US
Telephone Number	:	605-755-2273
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN ASSISTANT
Name	:	TROY NEIL THOMPSON
Credential	:	PA-C
Telephone Number	:	701-213-9032

Provider Enumeration Date	:	07/15/2015
Last Update Date	:	07/15/2015

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Directions to “REGIONAL HEALTH ” Practice Location

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