Provider Demographics
NPI:1801893714
Name:ROCKY MOUNTAIN CARE
Entity type:Organization
Organization Name:ROCKY MOUNTAIN CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DEE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BANGERTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-397-4000
Mailing Address - Street 1:576 W. 900 S.
Mailing Address - Street 2:SUITE 260
Mailing Address - City:WOODS CROSS
Mailing Address - State:UT
Mailing Address - Zip Code:84010-8127
Mailing Address - Country:US
Mailing Address - Phone:801-397-4054
Mailing Address - Fax:801-397-4196
Practice Address - Street 1:5250 COMMERCE DR
Practice Address - Street 2:STE 310
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-7926
Practice Address - Country:US
Practice Address - Phone:801-397-4000
Practice Address - Fax:801-397-4959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10006-05171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty