Red Rock Medical Supply LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

RED ROCK MEDICAL SUPPLY LLC

Doing business as

Red Rock Medical Supply

Practice address

1763 W Marcon LN Ste 150
Meridian, ID 83642-8202

Phone

(801) 886-9700

Fax

(801) 415-9423

NPI assigned

Sep 10, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michelle Liskey

Title

Director of Operations

Phone

(801) 886-9700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Red Rock Medical Supply Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1619526811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 S 900 E STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022983",
            "telephone_number": "801-886-9700",
            "fax_number": "801-415-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1763 W MARCON LN STE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428202",
            "telephone_number": "801-886-9700",
            "fax_number": "801-415-9423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED ROCK MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-10",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "LISKEY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "801-886-9700"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396018545",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Rock Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Red Rock Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oxygen Equipment & Supplies (DME) in Meridian, ID
• Providers in Meridian, ID by specialty
• Oxygen Equipment & Supplies (DME) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.