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NPI Code Detail

MEDICARE: ROCKY MOUNTAIN CLINICS, LLC

MEDICARE: ROCKY MOUNTAIN CLINICS, LLC
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
1207Q00000XFamily Medicine Physician
2207QA0401XAddiction Medicine (Family Medicine) Physician

General Provider Information

NPI Number : 1851106751
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROCKY MOUNTAIN CLINICS, LLC
Provider Business Mailing Address
First Line : 1120 E ELIZABETH ST STE G2
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-4044
Country : US
Telephone Number : 970-443-8268
Fax Number :
Provider Business Practice Location Address
First Line : 1861 AUSTIN BLUFFS PKWY
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-7868
Country : US
Telephone Number : 970-493-9193
Fax Number :
Authorized Official
Title or Position : FACILITIES DIRECTOR
Name : PATRICIA MALOUFF
Credential :
Telephone Number : 970-443-8268
Provider Enumeration Date : 02/10/2025
Last Update Date : 02/10/2025

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Directions to “ROCKY MOUNTAIN CLINICS, LLC ” Practice Location

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