Provider Demographics
NPI:1164821450
Name:REGIONAL HEALTH PHYSICIANS INC
Entity Type:Organization
Organization Name:REGIONAL HEALTH PHYSICIANS INC
Other - Org Name:MASSA BERRY REGIONAL MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER, RHP
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-755-9042
Mailing Address - Street 1:PO BOX 9263
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-9263
Mailing Address - Country:US
Mailing Address - Phone:605-347-3616
Mailing Address - Fax:
Practice Address - Street 1:890 LAZELLE ST
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:SD
Practice Address - Zip Code:57785-1611
Practice Address - Country:US
Practice Address - Phone:605-347-3616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGIONAL HEALTH PHYSICIANS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD214794OtherCERTIFICATE OF ACCREDITATION