Healthcare Provider Details

I. General information

NPI: 1730108747
Provider Name (Legal Business Name): RANGELY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 12/10/2021
Certification Date: 12/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 EAGLE CREST DRIVE
RANGELY CO
81648-2109
US

IV. Provider business mailing address

225 EAGLE CREST DRIVE
RANGELY CO
81648-2109
US

V. Phone/Fax

Practice location:
  • Phone: 970-675-5011
  • Fax:
Mailing address:
  • Phone: 970-675-5011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KYLE WREN
Title or Position: CEO
Credential:
Phone: 970-675-5011