Provider Demographics
NPI:1003104381
Name:ROCKY MOUNTAIN HOLDINGS, LLC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN HOLDINGS, LLC
Other - Org Name:LIFENET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:J
Authorized Official - Last Name:KECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-792-7400
Mailing Address - Street 1:PO BOX 84621
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-5921
Mailing Address - Country:US
Mailing Address - Phone:909-915-2304
Mailing Address - Fax:402-952-2427
Practice Address - Street 1:5581 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830
Practice Address - Country:US
Practice Address - Phone:863-533-5168
Practice Address - Fax:863-533-8513
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIR METHODS CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-20
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL04963416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL420021732Medicaid