| Regis Healthcare Inc | |
|
2208 Fort Campbell Blvd Hopkinsville KY 42240-4665 | |
| (270) 885-5796 | |
| Not Available |
| Full Name | Regis Healthcare Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 2208 Fort Campbell Blvd, Hopkinsville, Kentucky |
| Authorized Official Name and Position | Jacquelyn Jayne Strickland (OWNER) |
| Authorized Official Contact | 2708855515 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Regis Healthcare Inc 2208 Fort Campbell Blvd Hopkinsville KY 42240-4665 Ph: () - | Regis Healthcare Inc 2208 Fort Campbell Blvd Hopkinsville KY 42240-4665 Ph: (270) 885-5796 |
| NPI Number | 1689261422 |
|---|---|
| Provider Enumeration Date | 12/28/2020 |
| Last Update Date | 12/28/2020 |
| Medicare PECOS PAC ID | 2365698099 |
|---|---|
| Medicare Enrollment ID | O20210222001007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689261422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Pavel Conovalciuc |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720017080 PECOS PAC ID: 4587673504 Enrollment ID: I20210917002370 |
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