1669569265 NPI number — RANGE REGIONAL HEALTH SERVICES

Table of content: (NPI 1669569265)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669569265 NPI number — RANGE REGIONAL HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RANGE REGIONAL HEALTH SERVICES
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:
1669569265
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
750 E 34TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIBBING
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55746-3553
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
218-262-4881
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
750 E 34TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIBBING
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55746-3553
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-262-4881
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FINK
Authorized Official First Name:
TOM
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
218-362-6638

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  331001 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 107936 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 125912 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 35A05ME . This is a "BLUE CROSS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 98-00372 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: P386 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 502847723 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 98-00523 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: NA920 . This is a "PREFERREDONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 987G3ME . This is a "BLUE CROSS CHIRO" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: CG7247 . This is a "RRPTAN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 502847721 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 98-00017 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 98-00522 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 110393 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 125913 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 502847722 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 67458 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 98-00370 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: CH5565 . This is a "RRPTAN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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