Provider Demographics
NPI: | 1154097657 |
---|---|
Name: | ROCKY MOUNTAIN HOLDINGS, LLC |
Entity type: | Organization |
Organization Name: | ROCKY MOUNTAIN HOLDINGS, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ASSISTANT SECRETARY |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SHARON |
Authorized Official - Middle Name: | J |
Authorized Official - Last Name: | KECK |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 303-792-7400 |
Mailing Address - Street 1: | PO BOX 713362 |
Mailing Address - Street 2: | |
Mailing Address - City: | CINCINNATI |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 45271-3362 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 888-636-4438 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 5305 ETGEN BLVD |
Practice Address - Street 2: | |
Practice Address - City: | SNYDER |
Practice Address - State: | TX |
Practice Address - Zip Code: | 79549-6113 |
Practice Address - Country: | US |
Practice Address - Phone: | 888-636-4438 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | AIR METHODS CORPORATION |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2021-08-17 |
Last Update Date: | 2021-08-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 3416A0800X | Transportation Services | Ambulance | Air Transport |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 3345373-01 | Medicaid |