Provider Demographics
NPI:1700390523
Name:ROCKY MOUNTAIN MOBILE ANESTHESIA SOLUTIONS, LLC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN MOBILE ANESTHESIA SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:303-945-4858
Mailing Address - Street 1:300 CENTER DR STE G225
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-8625
Mailing Address - Country:US
Mailing Address - Phone:303-945-4858
Mailing Address - Fax:720-645-1575
Practice Address - Street 1:300 CENTER DR STE G225
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-8625
Practice Address - Country:US
Practice Address - Phone:303-945-4858
Practice Address - Fax:720-645-1575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0991047367500000X
CO0015001367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty