Provider Demographics
NPI:1376847392
Name:MOFOCO, LLC
Entity Type:Organization
Organization Name:MOFOCO, LLC
Other - Org Name:ROCKY MOUNTAIN AIRE 'THE BREATH OF LIFE'
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:MORFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-262-3698
Mailing Address - Street 1:PO BOX 1414
Mailing Address - Street 2:
Mailing Address - City:SILVERTHORNE
Mailing Address - State:CO
Mailing Address - Zip Code:80498-1414
Mailing Address - Country:US
Mailing Address - Phone:970-262-3698
Mailing Address - Fax:970-468-9498
Practice Address - Street 1:256 ANNIE RD.
Practice Address - Street 2:SUITE C
Practice Address - City:SILVERTHORNE
Practice Address - State:CO
Practice Address - Zip Code:80498-1414
Practice Address - Country:US
Practice Address - Phone:970-262-3698
Practice Address - Fax:970-468-9498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO6510720001Medicare NSC