1316371925 NPI number — ROCKY MOUNTAIN HOLDINGS LLC DBA AIR METHODS KENTUCKY

Table of content: (NPI 1316371925)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316371925 NPI number — ROCKY MOUNTAIN HOLDINGS LLC DBA AIR METHODS KENTUCKY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROCKY MOUNTAIN HOLDINGS LLC DBA AIR METHODS KENTUCKY
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:
1316371925
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/20/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
621 CARNEGIE DR
Provider Second Line Business Mailing Address:
SUITE 205
Provider Business Mailing Address City Name:
SAN BERNARDINO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92408-3536
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-915-2317
Provider Business Mailing Address Fax Number:
402-952-2411

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
709 AIRPORT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT STERLING
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-915-2317
Provider Business Practice Location Address Fax Number:
402-952-2411
Provider Enumeration Date:
08/30/2013

Additional Information

Authorized Official

Authorized Official Last Name:
ALLEN
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
DENNIS
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
909-915-2371

Provider Taxonomy Codes

  • Taxonomy code: 3416A0800X , with the licence number:  7001 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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