Provider Demographics
NPI:1073751178
Name:REGIONAL HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:REGIONAL HEALTH SERVICES, INC.
Other - Org Name:FOOT & ANKLE PODIATRY CENTER OF NWPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:ROEBACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-877-4242
Mailing Address - Street 1:717 STATE ST
Mailing Address - Street 2:SUITE 16, LL
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1341
Mailing Address - Country:US
Mailing Address - Phone:814-877-7100
Mailing Address - Fax:814-877-2939
Practice Address - Street 1:120 E 2ND ST
Practice Address - Street 2:4TH FL
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1537
Practice Address - Country:US
Practice Address - Phone:814-877-3668
Practice Address - Fax:814-877-3624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-27
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty