Basic Information
| Provider Information | |||||||||
| NPI: | 1356813307 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | REGIONAL HEALTH PHYSICIANS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 860013 | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554860013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6057556100 | ||||||||
| FaxNumber: | 6057556101 | ||||||||
| Practice Location | |||||||||
| Address1: | 1635 CAREGIVER CIRCLE | ||||||||
| Address2: | |||||||||
| City: | RAPID CITY | ||||||||
| State: | SD | ||||||||
| PostalCode: | 577028529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6057556100 | ||||||||
| FaxNumber: | 6057556101 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/31/2018 | ||||||||
| LastUpdateDate: | 12/31/2018 | ||||||||
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| AuthorizedOfficialLastName: | LONGACRE | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT AOSMH | ||||||||
| AuthorizedOfficialTelephone: | 6057558899 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QH0700X | Y | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech |
No ID Information.