Healthcare Provider Details

I. General information

NPI: 1609287721
Provider Name (Legal Business Name): ROCKY MOUNTAIN HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2014
Last Update Date: 05/24/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

579 YELLOWSTONE ROAD
WEST YELLOWSTONE MT
59758
US

IV. Provider business mailing address

PO BOX 713362
CINCINNATI OH
45271-3362
US

V. Phone/Fax

Practice location:
  • Phone: 406-640-1615
  • Fax:
Mailing address:
  • Phone: 800-499-9495
  • Fax: 402-952-2419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number914
License Number StateMT

VIII. Authorized Official

Name: SHARON J KECK
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 303-792-7400