Provider Demographics
NPI:1093173304
Name:ADVANCED URGENT CARE LLC
Entity Type:Organization
Organization Name:ADVANCED URGENT CARE LLC
Other - Org Name:ADVANCED URGENT CARE AND OCCUPATIONAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STOCKTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-659-9700
Mailing Address - Street 1:112 S DENVER AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LUPTON
Mailing Address - State:CO
Mailing Address - Zip Code:80621-1306
Mailing Address - Country:US
Mailing Address - Phone:303-659-9700
Mailing Address - Fax:303-558-8222
Practice Address - Street 1:112 S DENVER AVE
Practice Address - Street 2:
Practice Address - City:FORT LUPTON
Practice Address - State:CO
Practice Address - Zip Code:80621-1306
Practice Address - Country:US
Practice Address - Phone:303-659-9700
Practice Address - Fax:303-558-8222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care