Healthcare Provider Details

I. General information

NPI: 1003846726
Provider Name (Legal Business Name): ROCKY MOUNTAIN RADIOLOGY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 11/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5285 MCWHINNEY BLVD SUITE 140
LOVELAND CO
80538-8863
US

IV. Provider business mailing address

1175 58TH AVE STE 202
GREELEY CO
80634-4808
US

V. Phone/Fax

Practice location:
  • Phone: 970-278-4181
  • Fax: 970-278-4180
Mailing address:
  • Phone: 970-495-0300
  • Fax: 970-224-9624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: DEANNA GOODMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 970-669-8881