Healthcare Provider Details
I. General information
NPI: 1346750288
Provider Name (Legal Business Name): BANNER URGENT CARE COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/05/2017
Last Update Date: 06/20/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2555 E 13TH ST STE 110
LOVELAND CO
80537-5134
US
IV. Provider business mailing address
2901 N CENTRAL AVE STE 160
PHOENIX AZ
85012-2702
US
V. Phone/Fax
- Phone: 970-820-4264
- Fax: 970-820-4278
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
STANDAGE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 602-747-4000