Provider Demographics
NPI:1295034494
Name:ROCKY MOUNTAIN MEDICAL LLC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRENDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-696-8148
Mailing Address - Street 1:5341 HARBOR LN
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-6506
Mailing Address - Country:US
Mailing Address - Phone:406-696-8148
Mailing Address - Fax:406-440-4656
Practice Address - Street 1:5341 HARBOR LN
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-6506
Practice Address - Country:US
Practice Address - Phone:406-696-8148
Practice Address - Fax:406-440-4656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies