Healthcare Provider Details

I. General information

NPI: 1992782239
Provider Name (Legal Business Name): RANGE REGIONAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 04/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 E 37TH ST STE 27
HIBBING MN
55746-2925
US

IV. Provider business mailing address

750 E 34TH ST
HIBBING MN
55746-2341
US

V. Phone/Fax

Practice location:
  • Phone: 218-262-6982
  • Fax: 218-262-1723
Mailing address:
  • Phone: 218-362-6657
  • Fax: 218-362-6619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number327737
License Number StateMN

VIII. Authorized Official

Name: MR. JOHN D KRITZ
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 218-362-6657