Provider Demographics
NPI:1316371925
Name:ROCKY MOUNTAIN HOLDINGS LLC DBA AIR METHODS KENTUCKY
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN HOLDINGS LLC DBA AIR METHODS KENTUCKY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-915-2371
Mailing Address - Street 1:621 CARNEGIE DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3536
Mailing Address - Country:US
Mailing Address - Phone:909-915-2317
Mailing Address - Fax:402-952-2411
Practice Address - Street 1:709 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:MOUNT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353
Practice Address - Country:US
Practice Address - Phone:909-915-2317
Practice Address - Fax:402-952-2411
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROCKY MOUNTAIN HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-30
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY70013416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
8046701Medicare PIN