=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821615238
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROCKY MOUNTAIN URGENT CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/01/2020
-----------------------------------------------------
Last Update Date | 04/26/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6080 W 92ND AVE STE 1000
-----------------------------------------------------
City | WESTMINSTER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80031-2935
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-429-9311
-----------------------------------------------------
Fax | 303-429-9399
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 174457
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80217-4457
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-945-3299
-----------------------------------------------------
Fax | 303-945-3303
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CORPORATE CONTROLLER
-----------------------------------------------------
Name | TRESA SWITZER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 303-341-4730
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------