Provider Demographics
NPI:1649720269
Name:REGIONAL HEALTH HOME PLUS, LLC
Entity type:Organization
Organization Name:REGIONAL HEALTH HOME PLUS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF INNOVATION OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:AMODEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-755-9216
Mailing Address - Street 1:PO BOX 860013
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55486-0013
Mailing Address - Country:US
Mailing Address - Phone:605-755-7649
Mailing Address - Fax:605-755-7884
Practice Address - Street 1:1906 LOMBARDY DR
Practice Address - Street 2:SUITE 101
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57703-4132
Practice Address - Country:US
Practice Address - Phone:605-755-3060
Practice Address - Fax:605-755-3061
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGIONAL HEALTH HOME PLUS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-06
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7566570003Medicare NSC