Healthcare Provider Details

I. General information

NPI: 1316652431
Provider Name (Legal Business Name): ROCKY MOUNTAIN INFUSION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7435 SISTERS GROVE SUITE 310
COLORADO SPRINGS CO
80923
US

IV. Provider business mailing address

7435 SISTERS GROVE SUITE 310
COLORADO SPRINGS CO
80923
US

V. Phone/Fax

Practice location:
  • Phone: 719-842-7682
  • Fax: 719-941-7326
Mailing address:
  • Phone: 719-842-7682
  • Fax: 719-941-7326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RYAN MCFERRIN
Title or Position: MANAGING MEMBER
Credential:
Phone: 719-842-7682