1285912030 NPI number — REGIONAL WEST PHYSICIANS CLINIC

Table of content: (NPI 1285912030)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285912030 NPI number — REGIONAL WEST PHYSICIANS CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGIONAL WEST PHYSICIANS CLINIC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285912030
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1248
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCOTTSBLUFF
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
69363-1248
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
308-630-2930
Provider Business Mailing Address Fax Number:
308-630-2939

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3911 AVENUE B
Provider Second Line Business Practice Location Address:
SUITE 1100
Provider Business Practice Location Address City Name:
SCOTTSBLUFF
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
69361-4617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
308-630-2100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/28/2011

Additional Information

Authorized Official

Authorized Official Last Name:
RESCH
Authorized Official First Name:
NED
Authorized Official Middle Name:
P
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
308-635-3711

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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