Provider Demographics
NPI:1871733998
Name:MONA RANE MD CHARTERED
Entity type:Organization
Organization Name:MONA RANE MD CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MONA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:620-624-8500
Mailing Address - Street 1:PO BOX 1197
Mailing Address - Street 2:
Mailing Address - City:LIBERAL
Mailing Address - State:KS
Mailing Address - Zip Code:67905-1197
Mailing Address - Country:US
Mailing Address - Phone:719-624-8500
Mailing Address - Fax:
Practice Address - Street 1:1715 N WEBER ST
Practice Address - Street 2:SUITE 260
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-7532
Practice Address - Country:US
Practice Address - Phone:719-277-7263
Practice Address - Fax:888-892-0621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-02
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO473492086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS102437Medicare PIN
KSH72022Medicare UPIN