Provider Demographics
NPI:1487803383
Name:BOULDER COMMUNITY HEALTH
Entity type:Organization
Organization Name:BOULDER COMMUNITY HEALTH
Other - Org Name:<UNAVAIL>
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:PO BOX 9019
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-9019
Mailing Address - Country:US
Mailing Address - Phone:303-415-7599
Mailing Address - Fax:303-530-5474
Practice Address - Street 1:6685 GUNPARK DRIVE EAST
Practice Address - Street 2:SUITE 110
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-0000
Practice Address - Country:US
Practice Address - Phone:303-415-7599
Practice Address - Fax:303-530-5474
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE COMMUNITY HOSPITAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-16
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCC9515OtherRAILROAD MEDICARE
CO04019121Medicaid
CO04019121Medicaid