Basic Information
| Provider Information | |||||||||
| NPI: | 1871128371 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | REGIONAL HEALTH REACH INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 65 GENESEE ST FL 1 | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146113201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853683720 | ||||||||
| FaxNumber: | 5853683723 | ||||||||
| Practice Location | |||||||||
| Address1: | 65 GENESEE ST FL 1 | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146113201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853683720 | ||||||||
| FaxNumber: | 5853683723 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2020 | ||||||||
| LastUpdateDate: | 09/17/2021 | ||||||||
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| AuthorizedOfficialLastName: | KINTER | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR 340B PROGRAM | ||||||||
| AuthorizedOfficialTelephone: | 5853683537 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
No ID Information.