Provider Demographics
NPI:1497011183
Name:REGIONAL HEALTH MANAGEMENT CORPORATION
Entity Type:Organization
Organization Name:REGIONAL HEALTH MANAGEMENT CORPORATION
Other - Org Name:ROANOKE RURAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPSCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-235-5015
Mailing Address - Street 1:469 PRICE ST
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:AL
Mailing Address - Zip Code:36274-2104
Mailing Address - Country:US
Mailing Address - Phone:334-863-2311
Mailing Address - Fax:334-863-5596
Practice Address - Street 1:469 PRICE ST
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:AL
Practice Address - Zip Code:36274-2104
Practice Address - Country:US
Practice Address - Phone:334-863-3229
Practice Address - Fax:334-863-5596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL01D0971902OtherCLIA