Provider Demographics
NPI:1386602068
Name:ROCKY MOUNTAIN HEART ASSOCIATES, P.C.
Entity type:Organization
Organization Name:ROCKY MOUNTAIN HEART ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MEHLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-284-3900
Mailing Address - Street 1:3655 LUTHERAN PARKWAY
Mailing Address - Street 2:SUITE #201
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6010
Mailing Address - Country:US
Mailing Address - Phone:720-284-3900
Mailing Address - Fax:303-420-9635
Practice Address - Street 1:3655 LUTHERAN PARKWAY
Practice Address - Street 2:SUITE #201
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6010
Practice Address - Country:US
Practice Address - Phone:720-284-3900
Practice Address - Fax:303-420-9635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04680047Medicaid
CO04680047Medicaid