MEDICARE: BANNER URGENT CARE COLORADO

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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1346750288
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BANNER URGENT CARE COLORADO

Provider Business Mailing Address
First Line	:	2901 N CENTRAL AVE STE 160
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85012-2702
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2555 E 13TH ST STE 110
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80537-5134
Country	:	US
Telephone Number	:	970-820-4264
Fax Number	:	970-820-4278

Authorized Official
Title or Position	:	VP
Name	:	PATRICK PENROSE
Credential	:
Telephone Number	:	602-747-4000

Provider Enumeration Date	:	10/05/2017
Last Update Date	:	04/16/2026

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