Provider Demographics
NPI:1568617025
Name:ROCKY MOUNTAIN MEDICAL SUPPLY
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARMAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:PISHKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-500-2442
Mailing Address - Street 1:8810 E HAMPDEN AVE
Mailing Address - Street 2:UNT# 103
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4913
Mailing Address - Country:US
Mailing Address - Phone:303-691-2373
Mailing Address - Fax:303-691-2383
Practice Address - Street 1:8810 E HAMPDEN AVE
Practice Address - Street 2:UNT# 103
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-4913
Practice Address - Country:US
Practice Address - Phone:303-691-2373
Practice Address - Fax:303-691-2383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies