Provider Demographics
NPI:1780655696
Name:RANGE REGIONAL HEALTH SERVICES
Entity Type:Organization
Organization Name:RANGE REGIONAL HEALTH SERVICES
Other - Org Name:UNIVERSITY MEDICAL CENTER MESABI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP/CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
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:55746-3522
Mailing Address - Country:US
Mailing Address - Phone:218-262-4881
Mailing Address - Fax:218-362-6163
Practice Address - Street 1:750 E 34TH ST
Practice Address - Street 2:
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-3522
Practice Address - Country:US
Practice Address - Phone:218-262-4881
Practice Address - Fax:218-362-6163
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RANGE REGIONAL HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-30
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN331001273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1006110OtherPREF 1
MN1685H CEOtherBLUE CROSS
MN50-25402OtherMEDICA
MN2090OtherHEALTH PARTNERS
MN5021809OtherUBH
MN502847703Medicaid
MN1561OtherHEALTH PARTNERS
MNH104 300096OtherUCARE
MN1006110OtherPREF 1