1518507680 NPI number — ROCK CREEK INVESTMENTS LLC

Table of content: (NPI 1518507680)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518507680 NPI number — ROCK CREEK INVESTMENTS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROCK CREEK INVESTMENTS 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:
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:
1518507680
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/05/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
930 W GOLF VIEW DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORO VALLEY
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85737-9131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-399-2146
Provider Business Mailing Address Fax Number:
888-371-2955

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1109 S RIFLE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80017-4526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-535-1401
Provider Business Practice Location Address Fax Number:
37-457-9973
Provider Enumeration Date:
01/07/2020

Additional Information

Authorized Official

Authorized Official Last Name:
PRICE
Authorized Official First Name:
NEAL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
MANGING PARTNER
Authorized Official Telephone Number:
541-399-2146

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 60589787 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 56121784 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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