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NPI Code Detail

MEDICARE: ROCKY MOUNTAIN HOLDINGS LLC

MEDICARE: ROCKY MOUNTAIN HOLDINGS 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
13416A0800XAir Ambulance29512GA

General Provider Information

NPI Number : 1861778052
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROCKY MOUNTAIN HOLDINGS LLC
Provider Business Mailing Address
First Line : 621 CARNEGIE DR
Second Line : STE 210
City : SAN BERNARDINO
State : CA
Zip : 92408-3536
Country : US
Telephone Number : 909-915-2303
Fax Number : 402-952-2411
Provider Business Practice Location Address
First Line : BLDG 2485, JECELIN ST
Second Line :
City : FORT BENNING
State : GA
Zip : 31905
Country : US
Telephone Number : 909-915-2303
Fax Number : 402-952-2411
Authorized Official
Title or Position : VP OF PATIENT BUSINESS SERVICES
Name : MARK KEENE
Credential :
Telephone Number : 909-915-2301
Provider Enumeration Date : 11/01/2011
Last Update Date : 11/01/2011

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Directions to “ROCKY MOUNTAIN HOLDINGS LLC ” Practice Location

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