Provider Demographics
NPI:1447880240
Name:ROCKY MOUNTAIN EMS INC
Entity type:Organization
Organization Name:ROCKY MOUNTAIN EMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOETZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-385-0200
Mailing Address - Street 1:5055 MARK DABLING BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3875
Mailing Address - Country:US
Mailing Address - Phone:719-362-8000
Mailing Address - Fax:270-744-8642
Practice Address - Street 1:5055 MARK DABLING BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3875
Practice Address - Country:US
Practice Address - Phone:719-362-8000
Practice Address - Fax:270-744-8642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000158137Medicaid