Provider Demographics
NPI:1750586889
Name:BOULDER ABORTION CLINIC PC
Entity type:Organization
Organization Name:BOULDER ABORTION CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:HERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH PHD
Authorized Official - Phone:303-447-1361
Mailing Address - Street 1:1130 ALPINE AVENUE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304
Mailing Address - Country:US
Mailing Address - Phone:303-447-1361
Mailing Address - Fax:303-447-0020
Practice Address - Street 1:1130 ALPINE AVENUE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304
Practice Address - Country:US
Practice Address - Phone:303-447-1361
Practice Address - Fax:303-447-0020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility