Provider Demographics
NPI:1740324136
Name:ROCKY MOUNTAIN MEDICAL SERVICES, INC.
Entity type:Organization
Organization Name:ROCKY MOUNTAIN MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:COLTRAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-489-7107
Mailing Address - Street 1:PO BOX 764
Mailing Address - Street 2:
Mailing Address - City:MEAD
Mailing Address - State:CO
Mailing Address - Zip Code:80542-0764
Mailing Address - Country:US
Mailing Address - Phone:303-489-7107
Mailing Address - Fax:303-774-9597
Practice Address - Street 1:4747 ARAPAHOE AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1131
Practice Address - Country:US
Practice Address - Phone:303-489-7107
Practice Address - Fax:303-774-9597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-18
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty