Provider Demographics
NPI:1821074196
Name:BOULDER COMMUNITY HEALTH
Entity Type:Organization
Organization Name:BOULDER COMMUNITY HEALTH
Other - Org Name:THE COMMUNITY HOSPITAL ASSOCIATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VICE PRESIDENT / CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUNSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:303-415-7433
Mailing Address - Street 1:4747 ARAPAHOE AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1131
Mailing Address - Country:US
Mailing Address - Phone:303-415-7000
Mailing Address - Fax:303-415-5220
Practice Address - Street 1:4747 ARAPAHOE AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1131
Practice Address - Country:US
Practice Address - Phone:303-415-7000
Practice Address - Fax:303-415-5220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-19
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO010323282N00000X, 284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05027008Medicaid
CO060027Medicare Oscar/Certification