Provider Demographics
NPI:1992782239
Name:RANGE REGIONAL HEALTH SERVICES
Entity type:Organization
Organization Name:RANGE REGIONAL HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:KRITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-362-6657
Mailing Address - Street 1:750 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-2341
Mailing Address - Country:US
Mailing Address - Phone:218-362-6657
Mailing Address - Fax:218-362-6619
Practice Address - Street 1:1101 E 37TH ST
Practice Address - Street 2:STE 27
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-2925
Practice Address - Country:US
Practice Address - Phone:218-262-6982
Practice Address - Fax:218-262-1723
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RANGE REGIONAL HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-28
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN327737251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
110515OtherUCARE
5900041OtherMEDICA
120026OtherFIRST PLAN
1006743OtherPREFERRED ONE
1685ACEOtherBLUE CROSS BLUE SHIELD
MN247183Medicare Oscar/Certification