Provider Demographics
NPI:1235424201
Name:REGIONAL HEALTH PHYSICIANS INC
Entity Type:Organization
Organization Name:REGIONAL HEALTH PHYSICIANS INC
Other - Org Name:REGIONAL MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR-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:605-716-8399
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:617-402-1000
Mailing Address - Fax:617-402-1099
Practice Address - Street 1:2805 FIFTH STREET
Practice Address - Street 2:REGIONAL MEDICAL CLINIC-PODIATRY
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-7306
Practice Address - Country:US
Practice Address - Phone:605-719-5700
Practice Address - Fax:605-719-5775
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGIONAL HEALTH PHYSICIANS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-17
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9165960Medicaid
SD9165960Medicaid