Provider Demographics
NPI:1063430346
Name:RANGELY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:RANGELY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-675-5011
Mailing Address - Street 1:225 EAGLE CREST DR.
Mailing Address - Street 2:
Mailing Address - City:RANGELY
Mailing Address - State:CO
Mailing Address - Zip Code:81648-2100
Mailing Address - Country:US
Mailing Address - Phone:970-675-5011
Mailing Address - Fax:970-675-5224
Practice Address - Street 1:225 EAGLE CREST DR.
Practice Address - Street 2:
Practice Address - City:RANGELY
Practice Address - State:CO
Practice Address - Zip Code:81648-2100
Practice Address - Country:US
Practice Address - Phone:970-675-5011
Practice Address - Fax:970-675-5224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0682282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO00073 RAOtherBLUE CROSS
CO05073002Medicaid
1881811107Medicare PIN
CO00073 RAOtherBLUE CROSS
1063430346Medicare PIN