Healthcare Provider Details

I. General information

NPI: 1386602068
Provider Name (Legal Business Name): ROCKY MOUNTAIN HEART ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 08/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3655 LUTHERAN PARKWAY SUITE #201
WHEAT RIDGE CO
80033-6010
US

IV. Provider business mailing address

3655 LUTHERAN PARKWAY SUITE #201
WHEAT RIDGE CO
80033-6010
US

V. Phone/Fax

Practice location:
  • Phone: 720-284-3900
  • Fax: 303-420-9635
Mailing address:
  • Phone: 720-284-3900
  • Fax: 303-420-9635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ZACHARY C MEHLE
Title or Position: BUSINESS MANAGER
Credential:
Phone: 720-284-3900