Provider Demographics
NPI:1609057744
Name:REGIONAL HEALTH PHYSICIANS INC
Entity Type:Organization
Organization Name:REGIONAL HEALTH PHYSICIANS INC
Other - Org Name:BUFFALO REGIONAL MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO RHN
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GIESEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-719-8706
Mailing Address - Street 1:PO BOX 207
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:SD
Mailing Address - Zip Code:57720-0207
Mailing Address - Country:US
Mailing Address - Phone:605-375-3744
Mailing Address - Fax:605-375-3745
Practice Address - Street 1:209 RAMSLAND
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:SD
Practice Address - Zip Code:57720-0207
Practice Address - Country:US
Practice Address - Phone:605-375-3744
Practice Address - Fax:605-375-3745
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGIONAL HEALTH PHYSICIANS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-16
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS102252Medicare PIN