Provider Demographics
NPI:1780190801
Name:URGENT CARE SOLUTIONS GLENDALE, PC
Entity Type:Organization
Organization Name:URGENT CARE SOLUTIONS GLENDALE, PC
Other - Org Name:AFC URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:QUALITY ASSURANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:THERAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-757-1500
Mailing Address - Street 1:3800 IRVING ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-1935
Mailing Address - Country:US
Mailing Address - Phone:303-757-1500
Mailing Address - Fax:303-953-1449
Practice Address - Street 1:777 E SPEER BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-4262
Practice Address - Country:US
Practice Address - Phone:303-757-1500
Practice Address - Fax:303-953-1449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-27
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0034804261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06609767Medicaid
CO272802OtherMEDICARE PTAN