1942554852 NPI number — ROCKY MOUNTAIN HOLDINGS, LLC

Table of content: (NPI 1942554852)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942554852 NPI number — ROCKY MOUNTAIN HOLDINGS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROCKY MOUNTAIN HOLDINGS, LLC
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:
LIFENET AIR MEDICAL SERVICES
Provider Other Organization Name Type Code:
3
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:
1942554852
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
625 CARNEGIE DR
Provider Second Line Business Mailing Address:
SUITE 150
Provider Business Mailing Address City Name:
SAN BERNARDINO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92408-3510
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-636-4438
Provider Business Mailing Address Fax Number:
402-952-2423

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 NW ROSECRANS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT JOSEPH
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64503-4008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-232-3441
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/30/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MYERS
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
BROCK
Authorized Official Title or Position:
SENIOR VICE PRESIDENT, PBS
Authorized Official Telephone Number:
888-636-4438

Provider Taxonomy Codes

  • Taxonomy code: 3416A0800X , with the licence number:  307001 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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