Provider Demographics
NPI:1609823749
Name:REGIONAL HEALTH PHYSICIANS, INC.
Entity Type:Organization
Organization Name:REGIONAL HEALTH PHYSICIANS, INC.
Other - Org Name:SPEARFISH REGIONAL SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HARLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-642-3113
Mailing Address - Street 1:1316 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-1530
Mailing Address - Country:US
Mailing Address - Phone:605-642-3113
Mailing Address - Fax:605-642-3117
Practice Address - Street 1:1316 N 10TH ST
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-1530
Practice Address - Country:US
Practice Address - Phone:605-642-3113
Practice Address - Fax:605-642-3117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD11151282N00000X
367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care HospitalGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY114951200Medicaid
SD20184OtherDAKOTACARE PROVIDER NUMBE
SD5508060Medicaid
SD80094OtherBCBS PROVIDER NUMBER
SD0108060Medicaid
MT412139Medicaid
SD20184OtherDAKOTACARE PROVIDER NUMBE
WY114951200Medicaid