Provider Demographics
NPI:1366980211
Name:RANGER ORTHOPEDIC LLC
Entity type:Organization
Organization Name:RANGER ORTHOPEDIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-709-9330
Mailing Address - Street 1:3929 AIRPORT BLVD
Mailing Address - Street 2:BUILDING 1, SUITE 115
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-1987
Mailing Address - Country:US
Mailing Address - Phone:251-709-9330
Mailing Address - Fax:
Practice Address - Street 1:3929 AIRPORT BLVD
Practice Address - Street 2:BUILDING 1, SUITE 115
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-1987
Practice Address - Country:US
Practice Address - Phone:251-709-9330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies