Healthcare Provider Details

I. General information

NPI: 1679526685
Provider Name (Legal Business Name): ROCKY MOUNTAIN MEDICAL EQUIPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 11/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5620 N UNION BLVD
COLORADO SPRINGS CO
80918-1940
US

IV. Provider business mailing address

5620 N UNION BLVD
COLORADO SPRINGS CO
80918-1940
US

V. Phone/Fax

Practice location:
  • Phone: 719-593-0911
  • Fax: 719-594-0238
Mailing address:
  • Phone: 719-593-0911
  • Fax: 719-594-0238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: JODY R WRIGHT
Title or Position: PRESIDENT
Credential:
Phone: 303-806-8001