1386602068 NPI number — ROCKY MOUNTAIN HEART ASSOCIATES, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386602068 NPI number — ROCKY MOUNTAIN HEART ASSOCIATES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROCKY MOUNTAIN HEART ASSOCIATES, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386602068
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3655 LUTHERAN PARKWAY
Provider Second Line Business Mailing Address:
SUITE #201
Provider Business Mailing Address City Name:
WHEAT RIDGE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80033-6010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-284-3900
Provider Business Mailing Address Fax Number:
303-420-9635

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3655 LUTHERAN PARKWAY
Provider Second Line Business Practice Location Address:
SUITE #201
Provider Business Practice Location Address City Name:
WHEAT RIDGE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80033-6010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-284-3900
Provider Business Practice Location Address Fax Number:
303-420-9635
Provider Enumeration Date:
05/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MEHLE
Authorized Official First Name:
ZACHARY
Authorized Official Middle Name:
C
Authorized Official Title or Position:
BUSINESS MANAGER
Authorized Official Telephone Number:
720-284-3900

Provider Taxonomy Codes

  • Taxonomy code: 207RI0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207UN0901X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0204X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 04680047 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".