Provider Demographics
NPI:1477042281
Name:ROCKY MOUNTAIN HOLDINGS, LLC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN HOLDINGS, LLC
Other - Org Name:BAYFLITE
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 713362
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45271-3362
Mailing Address - Country:US
Mailing Address - Phone:888-636-4438
Mailing Address - Fax:
Practice Address - Street 1:3001 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6307
Practice Address - Country:US
Practice Address - Phone:813-870-4447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL70183416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL420021727Medicaid