Provider Demographics
NPI:1720128903
Name:ROCKY MOUNTAIN RESPIRATORY RESOURCE
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN RESPIRATORY RESOURCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:719-200-9697
Mailing Address - Street 1:11050 SPOTSWOOD TER
Mailing Address - Street 2:
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-4510
Mailing Address - Country:US
Mailing Address - Phone:719-200-9697
Mailing Address - Fax:
Practice Address - Street 1:11050 SPOTSWOOD TER
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831-4510
Practice Address - Country:US
Practice Address - Phone:719-200-9697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5569790001332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO42977339Medicaid
CO42977339Medicaid