1447387519 NPI number — ROCKY MOUNTAIN WOMEN'S HEALTH CENTER, INC.

Table of content: (NPI 1447387519)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447387519 NPI number — ROCKY MOUNTAIN WOMEN'S HEALTH CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROCKY MOUNTAIN WOMEN'S HEALTH CENTER, INC.
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:
6
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:
1447387519
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 844839
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75284-4839
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-210-9143
Provider Business Mailing Address Fax Number:
314-432-9683

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1580 W ANTELOPE DR STE 290
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAYTON
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84041-1179
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-776-0880
Provider Business Practice Location Address Fax Number:
801-773-7399
Provider Enumeration Date:
02/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HOLT
Authorized Official First Name:
HOLDEN
Authorized Official Middle Name:
U
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
801-776-0880

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1447387519 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: CH0973 . This is a "RR MEDICARE" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".




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