Organization Name: | REGENCE HEALTH NETWORK INC |
NPI Number: | 1003813056 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICK C LOVE (CEO) |
Mailing Address: | 850 Martin Rd Amarillo |
State: | TX US |
Postal Code: | 791076814 |
Phone Number: | 8063747341 |
Fax Number: | 8063740316 |
NPI Enumeration Date: | 07/06/2005 |
NPI Last Update Date: | 05/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | F1756 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |