Provider Demographics
NPI:1588620355
Name:REGIONAL THERAPY SERVICES INC
Entity Type:Organization
Organization Name:REGIONAL THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUS OP ADM
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-985-2080
Mailing Address - Street 1:PO BOX 999
Mailing Address - Street 2:
Mailing Address - City:MOULTRIE
Mailing Address - State:GA
Mailing Address - Zip Code:31776-0999
Mailing Address - Country:US
Mailing Address - Phone:229-985-2080
Mailing Address - Fax:229-890-3397
Practice Address - Street 1:2410 W PLAZA DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5325
Practice Address - Country:US
Practice Address - Phone:850-385-6185
Practice Address - Fax:850-385-2580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10-6803261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL884818100Medicaid
FLR4UOtherBC
FL884818100Medicaid