Organization · NPI-2

Boulder Community Health

Clinic/Center · Longmont, CO

NPI number1700485372
StatusActive
Last updated in NPPESOct 23, 2020

Details

NPI
1700485372
Entity type
Organization (NPI-2)
Legal business name
Boulder Community Health
Organization subpart
Yes
Enumeration date
Oct 23, 2020
Certification date
Oct 23, 2020
Last updated
Oct 23, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Other names

  • Boulder Heart Of Longmont (Doing Business As)

Practice location

2101 Ken Pratt Blvd Ste 104h
Longmont, CO 80501-6568

Phone 303-442-2395

Mailing address

4747 Arapahoe Ave
Boulder, CO 80303-1131

Phone 303-415-4700 · Fax 303-415-4701

Authorized official

Jay Pekarek
Reimbursement Specialist
3034154233

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