Healthcare Provider Details

I. General information

NPI: 1124452735
Provider Name (Legal Business Name): ROCKY MOUNTAIN HOLDINGS LLC DBA AIR METHODS KENTUCKY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2013
Last Update Date: 08/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

598 AIRPORT LN
SPRINGFIELD KY
40069-9607
US

IV. Provider business mailing address

621 CARNEGIE DR STE 205
SAN BERNARDINO CA
92408-3536
US

V. Phone/Fax

Practice location:
  • Phone: 909-915-2303
  • Fax: 402-952-2411
Mailing address:
  • Phone: 909-915-2303
  • Fax: 402-952-4011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number7001
License Number StateKY

VIII. Authorized Official

Name: MR. MARK KEENE
Title or Position: VP PATIENT BUSINESS SERVICES
Credential:
Phone: 909-915-2301