Healthcare Provider Details

I. General information

NPI: 1992308118
Provider Name (Legal Business Name): ROCKY MOUNTAIN CANCER CENTERS, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 07/15/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11750 W 2ND PL STE 160
LAKEWOOD CO
80228-1724
US

IV. Provider business mailing address

7951 E MAPLEWOOD AVE STE 350
GREENWOOD VILLAGE CO
80111-4758
US

V. Phone/Fax

Practice location:
  • Phone: 303-430-2700
  • Fax: 303-430-2770
Mailing address:
  • Phone: 303-930-7895
  • Fax: 303-267-4477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: NANCY WORTHAM
Title or Position: SENIOR CREDENTIALING COORDINATOR
Credential:
Phone: 303-930-7803