Provider Demographics
NPI:1659528412
Name:REGIONAL WEST PHYSICIANS CLINIC
Entity Type:Organization
Organization Name:REGIONAL WEST PHYSICIANS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCNEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-635-3711
Mailing Address - Street 1:4021 AVENUE B
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-4602
Mailing Address - Country:US
Mailing Address - Phone:308-630-1111
Mailing Address - Fax:308-630-1815
Practice Address - Street 1:302 CENTER AVE
Practice Address - Street 2:
Practice Address - City:MORRILL
Practice Address - State:NE
Practice Address - Zip Code:69358-3017
Practice Address - Country:US
Practice Address - Phone:308-247-3475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGIONAL WEST PHYSICIANS CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-25
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE283821Medicare Oscar/Certification