=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467856260
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROCKY MOUNTAIN HEALTHCARE COMPANY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/22/2014
-----------------------------------------------------
Last Update Date | 10/22/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 95 CASCADE DRIVE
-----------------------------------------------------
City | OURAY
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81427
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-729-3679
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1863
-----------------------------------------------------
City | OURAY
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81427-1863
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MS. CHERYL NIEHAUS
-----------------------------------------------------
Credential | R.N.
-----------------------------------------------------
Telephone | 858-729-3679
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------