Provider Demographics
NPI:1699813832
Name:ROCKY MOUNTAIN SLEEP CENTER LLC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN SLEEP CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:BLATCHFORD
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT, CRT
Authorized Official - Phone:720-874-9622
Mailing Address - Street 1:9233 PARK MEADOWS DR
Mailing Address - Street 2:SUITE 214
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5426
Mailing Address - Country:US
Mailing Address - Phone:720-874-9622
Mailing Address - Fax:720-874-9623
Practice Address - Street 1:9233 PARK MEADOWS DR
Practice Address - Street 2:SUITE 214
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5426
Practice Address - Country:US
Practice Address - Phone:720-874-9622
Practice Address - Fax:720-874-9623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO07876480000291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1093772550Medicare ID - Type UnspecifiedWILL USE 1699813832