Provider Demographics
NPI:1710966460
Name:ROCKY MOUNTAIN TOX, LLC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN TOX, LLC
Other - Org Name:CORDANT HEALTH SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MGR OF CREDENTIALING/ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-304-7602
Mailing Address - Street 1:12015 E 46TH AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-3107
Mailing Address - Country:US
Mailing Address - Phone:855-895-8090
Mailing Address - Fax:303-371-0345
Practice Address - Street 1:1701 CHAMBERS ROAD
Practice Address - Street 2:SUITE J
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-4666
Practice Address - Country:US
Practice Address - Phone:303-749-0443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO73051845Medicaid
CO73051845Medicaid