Provider Demographics
NPI:1861415242
Name:ROCKY MOUNTAIN OPENSCAN MRI, LLC
Entity type:Organization
Organization Name:ROCKY MOUNTAIN OPENSCAN MRI, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-303-2776
Mailing Address - Street 1:2200 ROSS AVE
Mailing Address - Street 2:3600 JPMORGAN CHASE TOWER
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-2708
Mailing Address - Country:US
Mailing Address - Phone:214-303-2776
Mailing Address - Fax:214-303-2732
Practice Address - Street 1:6950 E BELLEVIEW AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1618
Practice Address - Country:US
Practice Address - Phone:303-770-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC523498Medicare ID - Type UnspecifiedMEDICARE ID NUMBER
COC520318Medicare ID - Type UnspecifiedMEDICARE ID NUMBER