Provider Demographics
NPI:1245356989
Name:ROCKY MOUNTAIN DIAGNOSTICS, INC
Entity type:Organization
Organization Name:ROCKY MOUNTAIN DIAGNOSTICS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MANZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:719-477-0039
Mailing Address - Street 1:703 N TEJON ST STE C
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1050
Mailing Address - Country:US
Mailing Address - Phone:719-477-0039
Mailing Address - Fax:719-477-0307
Practice Address - Street 1:AM EICHENHAIN 1
Practice Address - Street 2:
Practice Address - City:NORDHORN
Practice Address - State:NIEDERSACHSEN
Practice Address - Zip Code:48531
Practice Address - Country:DE
Practice Address - Phone:4959217-272-8105
Practice Address - Fax:4959217-272-8106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory