Provider Demographics
NPI:1902862592
Name:REGIONAL HEALTH CENTER OF RICHMOND, INC.
Entity Type:Organization
Organization Name:REGIONAL HEALTH CENTER OF RICHMOND, INC.
Other - Org Name:SPICER HEALTH CENTER, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:LOUREY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-210-1663
Mailing Address - Street 1:307 IVY AVE SE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MN
Mailing Address - Zip Code:56368
Mailing Address - Country:US
Mailing Address - Phone:320-597-8999
Mailing Address - Fax:320-597-8995
Practice Address - Street 1:307 IVY AVE SE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MN
Practice Address - Zip Code:56368
Practice Address - Country:US
Practice Address - Phone:320-597-8999
Practice Address - Fax:320-597-8995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-24
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN003166111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
647220600OtherMEDICAL ASSISTANCE
31G09SPOtherBLUE CROSS BLUE SHIELD GR
350049912OtherRAILROAD MEDICARE
411508205OtherAETNA & SIGNA PREFERRED O
1016069OtherHEALTH SERVICE MANAGEMENT
31G09SPOtherBLUE CROSS BLUE SHIELD
=========OtherWK COMP PERS INJ UCARE ME
350049912OtherRAILROAD MEDICARE
=========OtherWK COMP PERS INJ UCARE ME