Provider Demographics
NPI:1497894026
Name:ROCKY MOUNTAIN HOSPICE
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-294-0785
Mailing Address - Street 1:2110 OVERLAND AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6440
Mailing Address - Country:US
Mailing Address - Phone:406-294-0785
Mailing Address - Fax:406-294-0788
Practice Address - Street 1:2110 OVERLAND AVE STE 111
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6440
Practice Address - Country:US
Practice Address - Phone:406-294-0785
Practice Address - Fax:406-294-0788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10503251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0750244Medicaid
MT0750244Medicaid