Basic Information
| Provider Information | |||||||||
| NPI: | 1457515546 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | REGIONAL HEALTH SERVICES, INC. | ||||||||
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| OtherOrganizationName: | HAMOT FLAGSHIPCVTS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 717 STATE STREET | ||||||||
| Address2: | SUITE 16, LL | ||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165011360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144807100 | ||||||||
| FaxNumber: | 8144807604 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 EAST 2ND STREET | ||||||||
| Address2: | 4TH FLOOR | ||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165071537 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144536751 | ||||||||
| FaxNumber: | 8144561859 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2008 | ||||||||
| LastUpdateDate: | 07/17/2008 | ||||||||
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| AuthorizedOfficialLastName: | FIORENZO | ||||||||
| AuthorizedOfficialFirstName: | V | ||||||||
| AuthorizedOfficialMiddleName: | JAMES | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8148776588 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | REGIONAL HEALTH SERVICES, INC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208G00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
No ID Information.