Provider Demographics
NPI:1942554852
Name:ROCKY MOUNTAIN HOLDINGS, LLC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN HOLDINGS, LLC
Other - Org Name:LIFENET AIR MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT, PBS
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:BROCK
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-636-4438
Mailing Address - Street 1:625 CARNEGIE DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3510
Mailing Address - Country:US
Mailing Address - Phone:888-636-4438
Mailing Address - Fax:402-952-2423
Practice Address - Street 1:200 NW ROSECRANS RD
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64503-4008
Practice Address - Country:US
Practice Address - Phone:816-232-3441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIR METHODS CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-30
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO3070013416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO9004057Medicare PIN