Healthcare Provider Details

I. General information

NPI: 1871550145
Provider Name (Legal Business Name): RANGELY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 12/10/2021
Certification Date: 12/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 EAGLE CREST DR
RANGELY CO
81648-3105
US

IV. Provider business mailing address

225 EAGLE CREST
RANGELY CO
81648
US

V. Phone/Fax

Practice location:
  • Phone: 970-675-5011
  • Fax: 970-675-4228
Mailing address:
  • Phone: 970-675-5011
  • Fax: 970-675-4228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number0681
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number011132
License Number StateCO

VIII. Authorized Official

Name: NICK RIGGIO
Title or Position: CREDENTIALING AND VERIFICATION
Credential:
Phone: 970-675-4207