Provider Demographics
NPI:1447897335
Name:BOULDER COMMUNITY HEALTH
Entity type:Organization
Organization Name:BOULDER COMMUNITY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/V.P. FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-854-7433
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:303-415-4700
Mailing Address - Fax:303-415-4701
Practice Address - Street 1:2150 STADIUM DRIVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80309-0001
Practice Address - Country:US
Practice Address - Phone:303-315-9900
Practice Address - Fax:303-315-9902
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOULDER COMMUNITY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory