Healthcare Provider Details

I. General information

NPI: 1811292360
Provider Name (Legal Business Name): DENVER URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2011
Last Update Date: 01/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5165 W 72ND AVE
WESTMINSTER CO
80030-5137
US

IV. Provider business mailing address

PO BOX 15430
LOVES PARK IL
61132-5430
US

V. Phone/Fax

Practice location:
  • Phone: 303-645-4770
  • Fax: 303-645-4880
Mailing address:
  • Phone: 815-713-2600
  • Fax: 815-654-8020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number2972001
License Number StateCO

VIII. Authorized Official

Name: DR. LEE MOORER
Title or Position: MD/OWNER
Credential: MD
Phone: 303-645-4770