MEDICARE: BOULDER COMMUNITY HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1114876380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOULDER COMMUNITY HEALTH

Provider Business Mailing Address
First Line	:	PO BOX 9049
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80301-9049
Country	:	US
Telephone Number	:	303-415-5300
Fax Number	:

Provider Business Practice Location Address
First Line	:	6685 GUNPARK DR STE 110B
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80301-3343
Country	:	US
Telephone Number	:	303-415-4101
Fax Number	:

Authorized Official
Title or Position	:	VP/CFO
Name	:	WILLIAM A MUNSON JR.
Credential	:
Telephone Number	:	303-485-7433

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

Similar Medicare Providers

1437138369 — SHANE AUGUST JUENEMANN M.D.
Practice Location Address:

6685 GUNPARK DR STE 110
BOULDER, CO
80301-3343

Practice Phone: 303-530-3062
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1427287259 — JOANNA MARIA PLONSKA MD
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1215404595 — SCOTT DAVID PARKER FNP-BC
Practice Location Address:

6685 GUNPARK DR STE 102
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80301-3343

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Practice Fax:

1972071090 — JULIE ANN VANDUINE FNP
Practice Location Address:

6685 GUNPARK DR STE 102
BOULDER, CO
80301-3343

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1841843026 — RANDOLPH S DAVIS N.P.
Practice Location Address:

6685 GUNPARK DR STE 102
BOULDER, CO
80301-3343

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1740837210 — BOULDER COMMUNITY HEALTH
Practice Location Address:

6685 GUNPARK DR STE 102
BOULDER, CO
80301-3343

Practice Phone: 303-415-5199
Practice Fax: 303-415-5198

Directions to “BOULDER COMMUNITY HEALTH ” Practice Location

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