Provider Demographics
NPI:1548263718
Name:ROCKY MOUNTAIN MEDICAL EQUIPMENT LLC
Entity type:Organization
Organization Name:ROCKY MOUNTAIN MEDICAL EQUIPMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-227-6285
Mailing Address - Street 1:6820 N COUNTY ROAD 13
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-1255
Mailing Address - Country:US
Mailing Address - Phone:970-227-6285
Mailing Address - Fax:970-776-1966
Practice Address - Street 1:1649 MAIN ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-2614
Practice Address - Country:US
Practice Address - Phone:303-651-6400
Practice Address - Fax:303-678-4837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO02501031Medicaid
CO1319460001Medicare NSC