Provider Demographics
NPI:1922659044
Name:BOULDER COMMUNITY HEALTH
Entity Type:Organization
Organization Name:BOULDER COMMUNITY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, CFO
Authorized Official - Prefix:
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 1:5450 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2709
Mailing Address - Country:US
Mailing Address - Phone:303-415-8880
Mailing Address - Fax:303-415-8888
Practice Address - Street 1:4880 RIVERBEND RD STE 100
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2622
Practice Address - Country:US
Practice Address - Phone:303-415-8880
Practice Address - Fax:303-415-8888
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOULDER COMMUNITY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty