Provider Demographics
NPI:1033271929
Name:ROCKY MOUNTAIN CHILDREN'S HEALTH FOUNDATION
Entity type:Organization
Organization Name:ROCKY MOUNTAIN CHILDREN'S HEALTH FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MILK BANK DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-869-1888
Mailing Address - Street 1:5394 MARSHALL ST STE 400
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-3947
Mailing Address - Country:US
Mailing Address - Phone:303-869-1888
Mailing Address - Fax:303-839-7336
Practice Address - Street 1:5394 MARSHALL ST STE 400
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-3947
Practice Address - Country:US
Practice Address - Phone:303-869-1888
Practice Address - Fax:303-839-7336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08003378Medicaid