MEDICARE: BAPTIST HOME ASSOCIATION OF THE ROCKY MOUNTAINS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility		CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831187632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAPTIST HOME ASSOCIATION OF THE ROCKY MOUNTAINS INC

Provider Business Mailing Address
First Line	:	4800 TABOR ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80033-2112
Country	:	US
Telephone Number	:	303-421-4161
Fax Number	:	303-424-6152

Provider Business Practice Location Address
First Line	:	4800 TABOR ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80033-2112
Country	:	US
Telephone Number	:	303-421-4161
Fax Number	:	303-424-6152

Authorized Official
Title or Position	:	DIRECTOR OF REIMBURSEMENT
Name	:	DEBORAH A KOTCHER
Credential	:
Telephone Number	:	952-253-1485

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	12/14/2007

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