Healthcare Provider Details

I. General information

NPI: 1073848305
Provider Name (Legal Business Name): ROCKY MOUNTAIN MEDICAL , LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 S ALTON WAY STE B240
CENTENNIAL CO
80112-2276
US

IV. Provider business mailing address

12350 NW 39TH ST STE 200
CORAL SPRINGS FL
33065-2418
US

V. Phone/Fax

Practice location:
  • Phone: 800-700-4246
  • Fax: 954-200-8730
Mailing address:
  • Phone: 800-700-4246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number602942924
License Number StateWA

VIII. Authorized Official

Name: TIMOTHY R JONES
Title or Position: COO
Credential:
Phone: 800-700-4246