Basic Information
| Provider Information | |||||||||
| NPI: | 1356321699 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | RANGE REGIONAL HEALTH SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 750 E 34TH ST | ||||||||
| Address2: | |||||||||
| City: | HIBBING | ||||||||
| State: | MN | ||||||||
| PostalCode: | 557463553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2182624881 | ||||||||
| FaxNumber: | 2183626163 | ||||||||
| Practice Location | |||||||||
| Address1: | 750 E 34TH ST | ||||||||
| Address2: | |||||||||
| City: | HIBBING | ||||||||
| State: | MN | ||||||||
| PostalCode: | 557463553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2182624881 | ||||||||
| FaxNumber: | 2183626163 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/20/2006 | ||||||||
| LastUpdateDate: | 09/05/2020 | ||||||||
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| AuthorizedOfficialLastName: | FINK | ||||||||
| AuthorizedOfficialFirstName: | TOM | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 2183626638 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 331001 | MN | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 068512700 | 05 | MN | MEDICAID | 1006110 | 01 | MN | PREF 1 | OTHER | 2090 | 01 | MN | HEALTHPARTNERS | OTHER | 69208EM | 01 | MN | BLUE CROSS | OTHER | H104 300096 | 01 | MN | UCARE | OTHER | 92066 | 01 | MN | PREFERREDONE | OTHER | 08G67UN | 01 | MN | BLUE CROSS | OTHER | 502847700 | 05 | MN | MEDICAID | 83-00130 | 01 | MN | MEDICA | OTHER | 98-39153 | 01 | MN | MEDICA | OTHER | H104 331227 | 01 | MN | UCARE | OTHER | CG7247 | 01 | MN | RRPTAN | OTHER | 1561 | 01 | MN | HEALTHPARTNERS | OTHER | 1685H CE | 01 | MN | BLUE CROSS BLUE SHIELD | OTHER | CH5565 | 01 | MN | RRPTAN | OTHER | 50-25402 | 01 | MN | MEDICA | OTHER | 60255ME | 01 | MN | BLUE CROSS | OTHER |