1528530664 NPI number — REGIONAL HEALTH PHYSICIANS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528530664 NPI number — REGIONAL HEALTH PHYSICIANS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGIONAL HEALTH PHYSICIANS, INC.
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:
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:
1528530664
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/31/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 860013
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55486-0013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-755-6100
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1635 CAREGIVER CIRCLE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RAPID CITY
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57702-8529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-755-6100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/31/2018

Additional Information

Authorized Official

Authorized Official Last Name:
LONGACRE
Authorized Official First Name:
MARK
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT AOSMH
Authorized Official Telephone Number:
605-755-8899

Provider Taxonomy Codes

  • Taxonomy code: 261QX0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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