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NPI Code Detail

MEDICARE: ROCKY MOUNTAIN YOUTH MEDICAL AND NURSING CONSULTANTS, INC

MEDICARE: ROCKY MOUNTAIN YOUTH MEDICAL AND NURSING CONSULTANTS, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician
22080A0000XPediatric Adolescent Medicine Physician
3261Q00000XClinic/Center
4261QM1300XMulti-Specialty Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497355382
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROCKY MOUNTAIN YOUTH MEDICAL AND NURSING CONSULTANTS, INC
Provider Business Mailing Address
First Line : 9197 GRANT ST STE 100
Second Line :
City : THORNTON
State : CO
Zip : 80229-4331
Country : US
Telephone Number : 303-450-3690
Fax Number :
Provider Business Practice Location Address
First Line : 1630 S ACOMA ST
Second Line :
City : DENVER
State : CO
Zip : 80223-3602
Country : US
Telephone Number : 303-450-3690
Fax Number : 303-962-1511
Authorized Official
Title or Position : DIRECTOR OF ADMINISTRATIVE OPERATIO
Name : PAUL BROWN
Credential :
Telephone Number : 303-450-3690
Provider Enumeration Date : 10/29/2020
Last Update Date : 05/05/2023

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