Provider Demographics
NPI:1972339083
Name:ROCKY AMBULATORY LLC
Entity type:Organization
Organization Name:ROCKY AMBULATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEZAHEGN
Authorized Official - Middle Name:ADUGNA
Authorized Official - Last Name:HIKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-388-4894
Mailing Address - Street 1:1005 S JAMAICA ST APT 109
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3162
Mailing Address - Country:US
Mailing Address - Phone:720-388-4894
Mailing Address - Fax:
Practice Address - Street 1:1005 S JAMAICA ST APT 109
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3162
Practice Address - Country:US
Practice Address - Phone:720-388-4894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport