Provider Demographics
NPI:1669569265
Name:RANGE REGIONAL HEALTH SERVICES
Entity type:Organization
Organization Name:RANGE REGIONAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:FINK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-362-6638
Mailing Address - Street 1:750 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-3553
Mailing Address - Country:US
Mailing Address - Phone:218-262-4881
Mailing Address - Fax:
Practice Address - Street 1:750 E 34TH ST
Practice Address - Street 2:
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-3553
Practice Address - Country:US
Practice Address - Phone:218-262-4881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RANGE REGIONAL HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-06
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN331001261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN107936OtherUCARE
MN125912OtherUCARE
MN35A05MEOtherBLUE CROSS
MN98-00372OtherMEDICA
MNP386OtherUCARE
MN502847723Medicaid
MN98-00523OtherMEDICA
MNNA920OtherPREFERREDONE
MN987G3MEOtherBLUE CROSS CHIRO
MNCG7247OtherRRPTAN
MN502847721Medicaid
MN98-00017OtherMEDICA
MN98-00522OtherMEDICA
MN110393OtherUCARE
MN125913OtherUCARE
MN502847722Medicaid
MN67458OtherHEALTH PARTNERS
MN98-00370OtherMEDICA
MNCH5565OtherRRPTAN
MNNA920OtherPREFERREDONE