Provider Demographics
NPI:1609275908
Name:REGIONAL HEALTH NETWORK, INC.
Entity Type:Organization
Organization Name:REGIONAL HEALTH NETWORK, INC.
Other - Org Name:HILL CITY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:H
Authorized Official - Last Name:SUGHRUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-755-8162
Mailing Address - Street 1:353 FAIRMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-7375
Mailing Address - Country:US
Mailing Address - Phone:605-755-9142
Mailing Address - Fax:605-755-9140
Practice Address - Street 1:238 ELM STREET
Practice Address - Street 2:
Practice Address - City:HILL CITY
Practice Address - State:SD
Practice Address - Zip Code:57745
Practice Address - Country:US
Practice Address - Phone:605-574-4470
Practice Address - Fax:605-574-4853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD431323Medicare PIN