Healthcare Provider Details

I. General information

NPI: 1669147914
Provider Name (Legal Business Name): ROCKY MOUNTAIN CANCER CENTERS LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2021
Last Update Date: 08/10/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1024 CENTRAL PARK DR
STEAMBOAT SPRINGS CO
80487-8813
US

IV. Provider business mailing address

7591 E. MAPLEWOOD AVE. SUITE 350
GREENWOOD VILLAGE CO
80111-4758
US

V. Phone/Fax

Practice location:
  • Phone: 970-879-1322
  • Fax: 970-870-1223
Mailing address:
  • Phone: 303-930-7803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

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