Provider Demographics
NPI:1962748400
Name:REGIONAL HEALTH PARTNERS LLC
Entity type:Organization
Organization Name:REGIONAL HEALTH PARTNERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:E
Authorized Official - Last Name:MEARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-528-2801
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:FL
Mailing Address - Zip Code:32696-2403
Mailing Address - Country:US
Mailing Address - Phone:352-528-2801
Mailing Address - Fax:352-528-1493
Practice Address - Street 1:125 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:FL
Practice Address - Zip Code:32696-2403
Practice Address - Country:US
Practice Address - Phone:352-529-0681
Practice Address - Fax:352-529-1420
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGIONAL HEALTH PARTNERS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health