MEDICARE: URGENT CARE OF COLORADO PC

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	261Q00000X	Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	804288	OTHER		PTAN

General Provider Information

NPI Number	:	1215998869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	URGENT CARE OF COLORADO PC

Provider Business Mailing Address
First Line	:	9116 W BOWLES AVE STE 3A
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80123-3476
Country	:	US
Telephone Number	:	303-904-2600
Fax Number	:

Provider Business Practice Location Address
First Line	:	9116 W BOWLES AVE STE 3A
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80123-3476
Country	:	US
Telephone Number	:	303-904-2600
Fax Number	:

Authorized Official
Title or Position	:	CEO, PRES
Name	:	SUSAN SIPAY
Credential	:	MD
Telephone Number	:	303-904-2600

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	03/17/2018

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