Provider Demographics
NPI:1750694477
Name:ADVANCED HEALTHCARE, P. C.
Entity type:Organization
Organization Name:ADVANCED HEALTHCARE, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:303-751-5255
Mailing Address - Street 1:10890 E DARTMOUTH AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80014-4845
Mailing Address - Country:US
Mailing Address - Phone:303-751-5255
Mailing Address - Fax:303-751-3225
Practice Address - Street 1:10890 E DARTMOUTH AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80014-4845
Practice Address - Country:US
Practice Address - Phone:303-751-5255
Practice Address - Fax:303-751-3225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1852261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service